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"Certification Examination for Competency in Cardiac Rhythm Device Therapy"
for the Physician
Exam Content Outline
Revised 2008
I. Fundamentals of Electrophysiology and
Electronics
3%
A. Pathophysiology and
Mechanisms of Dysrhythmias: Impulse Formation and Conduction
B. Electrophysiology of Dysrhythmias
C. Electronics; Sensing/Stimulation/Defibrillation
1.
Basic quantities
(ampere, charge, coulomb, ohm, volt, hertz)
2.
Derived quantities
(resistance, capacitance, battery capacity)
3.
Relationships (ohms
law, power, energy)
4.
Wave forms
II. Applied Science and Technology
25%
A. Pulse Generators
4%
1.
Energy sources
2.
Electronic circuit
components; capacitors, resistors, diodes
3.
Sensors; motion, QT,
MV, accelerometer, impedance
4.
Software [Firmware]
B. Leads and Electrode Materials
3%
1.
Insulation
2.
Conductors
3.
Connectors/adapters/ IS1
4.
Electrodes
5.
Shock coil
C. Sensing
2%
1.
Cardiac signals
2.
Extracardiac signals
D. Stimulation
3%
1.
Anode/cathode
stimulation
2.
Stimulation /
Defibrillation threshold
3.
Ohm's law: current,
voltage, and impedance (calculation of)
4.
Strength duration;
stimulation threshold
5.
Power and energy
E. Timing Cycles
5%
1.
Single chamber
2.
Dual chamber
3.
Rate modulation
4.
CRT (Biventricular)
F. Algorithms
4%
1.
Bradycardia/tachycardia
pacing therapy
2.
Tachyarrhythmia
detection
3.
SVT discrimination
4.
Antitachyarrhythmia pacing
G. Defibrillation Concepts
3%
H. Physiologic Monitors [Implantable]
1%
III. Pharmacology
3%
A. Drug/Device Interaction
B. Drug Effects on Cardiac Rhythm and Conduction
IV. Electrocardiography
3%
A. Electrocardiogram
1.
Paced Rhythms
B. Recognition of Dysrhythmias
V. Clinical Assessment
3%
A. History
B. Diagnostic Test Technologies
1.
Invasive
2.
Non-invasive
(includes echocardiography)
VI. Perioperative Practice / Clinical
Practice
20%
A. Indications for Device
Therapy and Placement
10%
1.
Bradyarrhythmias
2.
Tachyarrhythmias
3.
Chronic congestive
heart failure
4.
Syncope
B. Device and Feature Selection
6%
1.
Sinus node
dysfunction
2.
Atrioventricular
block
3.
Hemodynamics
4.
Pacing for
tachyarrhythmias
C. Surgical Technique
2%
1.
Patient preparation
(informed consent, documentation, chart review)
2.
Implantation
a.
intraoperative
testing
b.
surgical procedure;
lead placement
c.
conscious sedation;
IV analgesia, monitoring requirements
3.
Lead/pulse generator
removal/extraction
D. Surgical Complications
1%
1.
Intraoperative
2.
Postoperative
E. Pediatric Pacing
1%
VII. Safety
2%
A. Infection Control
B. Sterile Technique
C. Radiation Safety
D. Device EMI Interaction
VIII. Patient and Device Follow-up
Management
35%
A. Assessment [History,
Surgical site]
9%
B. Diagnostics; High Rate, Mode Switch Tabulation, EGM
C. Programming
8%
D. Device Assessment
8%
1.
Clinical;
rhythm therapy, rate modulation, hemodynamics
2.
Technological;
assessment of capture/sensing
3.
Natural
history of pulse generators/leads; lead maturation, PG longevity ERI,EO
4.
Programming
management
E. Pacing System Complications
7%
F. Remote Monitoring
2%
G. Documentation; Medical Charting 1%
IX. Clinical Trials
2%
A. Study Design
B. Outcomes
X. Radiology
3%
XI. Cardiac Life Support
1%
A. Defibrillation, Cardioversion, Rescue Pacing
Successful completion of the IBHRE
Certification Examination for Competency in Cardiac Rhythm Device Therapy
and/or IBHRE
Certification Examination for Competency in Cardiac Electrophysiology is not
a requirement to perform or participate in pacemaker related and/or
electrophysiology therapy, and does not attest to the overall capability or
competency of any physician or allied professional. These examinations are
written examinations only and do not include any testing in a practical setting.
IBHRE does not intend to interfere with or to restrict the professional
activity of a licensed physician because the physician has not successfully
completed the examination. Similarly, IBHRE does not intend to interfere
with or to restrict the professional activity of a non-physician because of
these examination processes.
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