Registered Cardiac Electrophysiology Specialist (RCES)

RCES:  Registered Cardiac Electrophysiology Specialist

Requires:  Passing the one-part Electrophysiology Registry Examination

Who Should Apply:  Professionals working in the area of electrophysiology

RCES Specialty Exam Fee: $350

Click here for information on ordering the Self Assessment Examination

RCES Navigation

Registered Cardiac Electrophysiology Specialist (RCES)

Qualification Requirements

All applicants must meet the following criteria:

  1. Have a high school diploma or general education diploma at the time of application.
  2. Fulfill one (1) of the qualifications of the exam for which you are applying. See qualifications listed in the tables below.
  3. Provide typed documentation to support the qualification under which you are applying. Required documentation for each qualification is listed below. CCI reserves the right to request additional information.
Qualification Prerequisite Supporting Documentation

(See examples on page 18)
RCES1-2013

Two years of full-time or full-time equivalent work experience in diagnostic and interventional cardiac electrophysiology. (It is anticipated, but NOT required that the successful candidate will have participated in a minimum of 200 diagnostic/ interventional cardiac electrophysiology studies and 300 device implants at the time of application.)

It is recommended, but not a requirement, that the applicant have experience in the following areas:

  • Diagnostic/Interventional Studies
  • Advanced Mapping
  • Device Implants (pacemaker, ICD, and CRT)
RCES1-2013

Employment Verification Letter

RCES235-2013

A graduate of a diploma, associate, or baccalaureate academic program in health science (including, but not limited to, cardiovascular technology, ultrasound, radiologic technology, respiratory therapy, or nursing)
AND
One year full-time work experience in electrophysiology

It is anticipated, but NOT required that the successful candidate will have participated in a minimum of 200 diagnostic/ interventional cardiac electrophysiology studies and 300 device implants at the time of application in their career which is defined as work experience and/or clinical experience gained during a formal educational program.

It is recommended, but not a requirement, that the applicant have experience in the following areas:

  • Diagnostic/Interventional Studies
  • Advanced Mapping
  • Device Implants (pacemaker, ICD and CRT)
RCES235-2013

Completion certificate and/or educational transcript
AND
Employment Verification Letter

RCES5

A graduate of a NON-programmatically accredited program in electrophysiology which has a minimum of one year of specialty training and includes a minimum of 800 clinical hours in the specialty in which the examination is being requested.

Students enrolled in NON-programmatically accredited program in electrophysiology with a start date prior to September 1, 2013 will be eligible to apply for their specific registry examinations under this current qualification pathway after they graduate.

RCES5

Completion certificate and/or educational transcript

AND

Student Verification Letter

AND

Clinical Experience Letter



RCES4

Applicant must be a graduate of a programmatically accredited** program in electrophysiology.

RCES4

Completion certificate and/or educational transcript

AND

Student Verification Letter

Students applying to take examination prior to graduation will be required to submit this documentation

IMPORTANT: If an individual’s clinical hours were obtained after graduation or if the hours are not a requirement for their educational program, then those hours WOULD NOT count toward the 800-hour minimum under qualification RCES5.

** An accredited program is accredited by an agency recognized by the Council for Higher Education Accreditation (CHEA), United States Department of Education (USDOE), or Canadian Medical Association (CMA) that specifically conducts programmatic accreditation for cardiovascular technology, diagnostic cardiac sonography, or vascular technology.

Click here for sample Employment Verification Letter, Student Verification Letter and Clinical Verification Letter (Graduates of Non-accredited Programs in EP).

CCI requires the Employment Verification Letter contain the following:

1) Employer’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by employer/supervisor.
3) Indicate the name of the applicant.
4) Indicate full- or part-time employment.
5) Indicate the time period of employment.
6) Indicate the primary duties of applicant, related to the field of cardiovascular technology.
7) Original signature of direct supervisor, who must be a MD or DO or hold an active RCCS, RCES, RCIS, RCS, RDCS, RDMS, RPhS, RVS, or RVT credential.

 

CCI requires the Student Verification Letter contain the following:

1) Educational program’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by educational director.
3) Indicate the name of the applicant.
4) Indicate full- or part-time student.
5) Indicate the date or expected date of graduation.
6) Indicate the specialty of the educational program.
7) For Non-programmatically accredited educational programs, indicate the program length, program specialty and the number and specialty of clinical hours accrued.
8) Original signature of the educational director.

 

CCI requires the Clinical Verification Letter contain the following:

1) Clinical Site’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by the clinical supervisor.
3) Indicate the name of the applicant.
4) Indicate the number of clinical hours.
5) Indicate the time period during which the clinical hours were performed.
6) Original signature of the clinical supervisor.
IMPORTANT: If an individual’s clinical hours were obtained after graduation or if the hours are not a requirement for their educational program, then those hours WOULD NOT count toward the 800 hour minimum under qualification RCES5.

 

Registered Cardiac Electrophysiology Specialist (RCES)

Examination Matrix

This examination matrix is provided to illustrate the general distribution of questions and the relative weight or emphasis given to a skill or content area on the examination.

Content Category Approximate Percentage of Examination
A. Conducting Pre-Procedural Activities 11%
B. Conducting Intra-Procedural Activities 22%
C. Conducting Post-Procedural Activities 3%
D. Performing Diagnostic Studies 28%
E. Performing Therapeutic Procedures 33%
F. Communicating with Patients and the Health Care Team 4%
Total 100%

Knowledge List

The list below describes general areas of knowledge that are needed in order to perform the tasks identified. This knowledge will apply across multiple tasks.

12-lead ECG placement and interpretation
Ablation physics
Arrhythmia recognition and diffrential diagnosis
ACLS
ACT equipment operation
General anatomy and physiology
Basic chemistry
Basic cardiac device technology
Basic electronics
Basic pharmacology
Basic radiology
Basic ultrasound
Biohazardous waste disposal
BLS
Body mechanics
Cabling connectology
Calibration of equipment
X-Ray camera angles
Cardiac action potential
Cardiac anatomy and physiology
Cardiovascular pathophysiology
Procedural equipment
Collection and handling of lab specimens
Congenital anomalies and EP (Ebstein’s, ASD, etc.)
Normal and abnormal/critical lab values
Defibrillation theory
Device programmer operation(s)
Intracardiac electrogram (EGM) interpretation
Electrocautery
Basic electrophysiology theory and concepts
Basic cardiac device theory
Equipment operation and compatability and troubleshooting
Hemodynamics
Hemostasis
Image processing and interpretation
Implantable cardiac device systems
Indications for electrophysiology procedures
Regulatory and legal issues (orders, consent, power of attorney, etc.)
Magnetic fields
Mapping concepts
Mechanisms of arrhythmias
Medical terminology
Medication administration and dosages
Monitoring equipment operations and troubleshooting
MSDS
Normal and abnormal vital signs
Pain management
Patient care and assessment
Patient positioning
Phlebotomy
Potential complications for all procedures (symptoms, treatment, etc.)
Moderate sedation
Sterile techniques
Stimulation protocols
Universal protocol
Vascular intervention procedures

Task List

The task list below describes the activities which an Electrophysiology Specialist is expected to perform on the job. All examination questions are linked to these tasks.

Duties and Tasks % of Exam
 
A Conducting Pre-Procedural Activities 11%
  Prepare procedure room  
  Prepare sterile table  
  Perform patient identification  
  Review patient laboratory results  
  Review patient medical record  
  Verify physician’s orders  
  Verify/obtain patient consent  
  Start patient IV  
  Transport patient to procedure room  
  Prepare patient for procedure  
     
B Conducting Intra-Procedural Activities 22%
  Maintain patient comfort  
  Monitor patient vital signs  
  Administer patient medications  
  Monitor ACT (Activated Clotting Time)  
  Acquire radiographic images  
  Evaluate implanted ICDs and pacemakers  
  Place central venous lines  
  Place arterial lines  
     
C Conducting Post-Procedural Activities 3%
  Remove arterial and venous sheath  
  Prepare patient for transfer to recovery  
  Reset procedure room  
Duties and Tasks % of Exam
 
D Performing Diagnostic Studies 28%
  Position diagnostic catheters  
  Analyze EGMs  
  Perform stimulation protocols  
  Perform differential diagnostic techniques  
  Perform peripheral venography  
  Perform tilt table testing  
     
E Performing Therapeutic Procedures 33%
  Assist physician with peripheral venoplasty  
  Assist with transeptal puncture  
  Perform arrhythmia mapping  
  Assist physician with ablation  
  Assist physician with lead extraction  
  Assist physician with periocardiocentisis  
  Assist physician with internal cardiac device implant  
     
F Communicating with the Physician and the Health Care Team 4%
  Summarize procedural data for physician  
  Provide patient report  
  Conduct patient education and training  
     
Total   100%

The textbooks listed below are intended as recommended resources when preparing for examination. You may have previous or later editions of these or other references available that also present acceptable coverage of the subject matter. Any general text in cardiovascular techniques and evaluation, and cardiac patient care and management may be used. It is not necessary to use all of the texts identified. They are provided as suggestions only. CCI does not endorse or recommend any third-party review course or material.

 

1. Ellenbogen, Kenneth A., and Bruce L. Wilkoff. Device therapy for congestive heart failure. Philadelphia: W.B. Saunders Co., 2004.
2. Ellenbogen, Kenneth A., and Mark A. Wood. Cardiac pacing and ICDs. 4th ed. Malden, Mass.: Blackwell Pub., 2005.
3. Fogoros, Richard N.. Electrophysiologic testing. 4th ed. Malden, Mass.: Blackwell Pub., 2006.
4. Hayes, David L., Paul Wang, Jonathan Sackner-Bernstein, and Samuel Asivatham. Resynchronization and defibrillation for heart failure a practical approach. 1st ed. Oxford, UK: Blackwell/Futura, 2004.
5. Hayes, David L., and Paul A. Friedman. Cardiac pacing, defibrillation and resynchronization: a clinical approach. 2nd ed. Chichester, West Sussex, UK: Wiley-Blackwell, 2008.
6. Murgatroyd, Francis D., George J. Klein, Andrew D. Krahn, Raymond Yee, and Allan Skanes. Handbook of Cardiac Electrophysiology a Practical Guide to Invasive EP Studies and Catheter Ablation.. 1st ed. London: Remedica Medical Education and Pub., 2002.
7. Opie, Lionel H.. Drugs for the heart. 7th ed. Philadelphia, PA: Saunders/Elsevier, 2009.
8. Podrid, Philip J., and Peter R. Kowey. Cardiac arrhythmia: mechanisms, diagnosis, and management. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 2001.
9. Wilber, David J., Douglas Packer, and William G. Stevenson. Catheter ablation of cardiac arrhythmias basic concepts and clinical applications. 3rd ed. Malden, Mass.: Blackwell, 2008.

10. ACLS Handbook, 2006 Revision, AHA.

 

Registered Cardiac Electrophysiology Specialist (RCES)

Sample Questions

  1. 1. Phase 2 of the action potential is dependent on ___________ influx.
    a. Sodium
    b. Calcium
    c. Chloride
    d. Potassium
  2. _________________ is a Class 1b antiarrhythmic.
    a. Flecainide b. Mexiletine
    c. Propafenone
    d. Procainamide
  3. During LV pacing, one would expect the QRS in V1 to be mostly
    a. Positive
    b. Biphasic
    c. Negative
    d. Isoelectric
  4. Which of the following programmed settings would be the safest and most efficient for a threshold that measured 2.0v @ 0.5 ms PW?
    a. 2.0 @ 1.5 ms PW
    b. 2.5V @ .06 ms PW
    c. 4.0 V @ 0.5 ms PW
    d. 4.0 V @ 1.0 ms PW
  5. The doctor orders isoproterenol to infuse at 3mcg/min. If the concentration is 1 mg in 250 cc, what is the rate in cc/hour?
    A. 4 cc/hour
    B. 12 cc/hour
    C. 45 cc/hour
    D. 60 cc/hour

A self-assessment examination is available for purchase for self-evaluation purposes. See pages 28-29 for more information.

Answers

1.b    2.b    3.c    4.c    5.c

RCES References

The textbooks listed below are intended as recommended resources when preparing for examination. You may have previous or later editions of these or other references available that also present acceptable coverage of the subject matter. Any general text in cardiovascular techniques and evaluation, and cardiac patient care and management may be used. It is not necessary to use all of the texts identified. They are provided as suggestions only. CCI does not endorse or recommend any third-party review course or material.

  1. Ellenbogen, Kenneth A., and Bruce L. Wilkoff. Device therapy for congestive heart failure. Philadelphia: W.B. Saunders Co., 2004.
  2. Ellenbogen, Kenneth A., and Mark A. Wood. Cardiac pacing and ICDs. 4th ed. Malden, Mass.: Blackwell Pub., 2005.
  3. Fogoros, Richard N.. Electrophysiologic testing. 4th ed. Malden, Mass.: Blackwell Pub., 2006.
  4. Hayes, David L., Paul Wang, Jonathan Sackner-Bernstein, and Samuel Asivatham. Resynchronization and defibrillation for heart failure a practical approach. 1st ed. Oxford, UK: Blackwell/Futura, 2004.
  5. Hayes, David L., and Paul A. Friedman. Cardiac pacing, defibrillation and resynchronization: a clinical approach. 2nd ed. Chichester, West Sussex, UK: Wiley-Blackwell, 2008.
  6. Murgatroyd, Francis D., George J. Klein, Andrew D. Krahn, Raymond Yee, and Allan Skanes. Handbook of Cardiac Electrophysiology a Practical Guide to Invasive EP Studies and Catheter Ablation.. 1st ed. London: Remedica Medical Education and Pub., 2002.
  7. Opie, Lionel H.. Drugs for the heart. 7th ed. Philadelphia, PA: Saunders/Elsevier, 2009.
  8. Podrid, Philip J., and Peter R. Kowey. Cardiac arrhythmia: mechanisms, diagnosis, and management. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 2001.
  9. Wilber, David J., Douglas Packer, and William G. Stevenson. Catheter ablation of cardiac arrhythmias basic concepts and clinical applications. 3rd ed. Malden, Mass.: Blackwell, 2008.
  10. ACLS Handbook, 2006 Revision, AHA.
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