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"Certification Examination of Competency in Cardiac Rhythm Device"
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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