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"Certification Examination for Competency in Cardiac Rhythm Device Therapy"
for the Allied Professional
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
2%
A. Drug/Device Interaction
B. Drug Effects on Cardiac Rhythm and
Conduction
IV.
Electrocardiography
4%
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
8%
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 3%
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
2%
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, EOL
4. Programming management
E. Pacing system complications 7%
F. Remote
monitoring
2%
G. Documentation; medical
charting 1%
IV. Clinical Trials 1%
A. Study design
B. Outcomes
X. Radiology
2%
XI. Cardiac Life
Support 3%
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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