CRAS study plan

Diagram the cardiac conduction system from SA node through Purkinje fibers, labeling each structure and its normal conduction velocity

Trace the cardiac cycle phase-by-phase and state which electrical event (P, QRS, T) corresponds to each mechanical event

Explain the ionic basis of each phase of the ventricular action potential (0-4) and identify which ion channel or current dominates each phase

Describe the three primary arrhythmia mechanisms (abnormal automaticity, triggered activity, reentry) and give one clinical rhythm example of each

Differentiate reentry from automaticity on a rhythm strip by applying rate, onset/offset, and response-to-pacing logic

Identify the ECG signature of each of the five major narrow-complex tachycardias and state the discriminating feature for each

Calculate rate, axis, and intervals (PR, QRS, QT) on 20 practice strips with documented accuracy

Classify heart blocks (first, second type I/II, third) using PR and P-QRS relationships on practice tracings

Interpret wide-complex tachycardia strips and justify ventricular versus supraventricular-with-aberrancy using at least four morphologic criteria

Map each Vaughan-Williams antiarrhythmic class to its primary ion channel target, key ECG effect, and one representative drug

State the proarrhythmic risk, monitoring parameter, and contraindication for each major antiarrhythmic drug

Explain anticoagulation decision logic for atrial fibrillation using a stroke-risk score and bleeding-risk score

Compare Holter, event monitor, patch monitor, and implantable loop recorder by duration, indication, and patient-selection criteria

Interpret a stress-test or tilt-table scenario and state what finding would confirm the suspected arrhythmia diagnosis

Describe pacemaker NBG code positions and match a programmed mode to a stated clinical scenario

Explain ICD detection and therapy tiers (antitachycardia pacing versus shock) and identify common causes of inappropriate ICD therapy

Identify pacemaker and ICD troubleshooting findings (undersensing, oversensing, failure to capture, lead fracture) from described tracings

Sequence the steps of an electrophysiology study from vascular access through programmed stimulation and mapping

Distinguish entrainment, resetting, and pacing maneuvers used to localize a reentrant circuit

Match ablation energy sources (radiofrequency, cryo, pulsed field) to their tissue effects and safety considerations

List pre-, intra-, and post-procedure nursing priorities for catheter ablation, including anticoagulation and sheath management

Explain indications, contraindications, and expected outcomes for ablation of AVNRT, atrial flutter, and atrial fibrillation

Build a patient-teaching script explaining antiarrhythmic adherence, side effects, and when to call the clinic

Demonstrate teach-back for a patient starting anticoagulation or a new antiarrhythmic

Describe remote monitoring workflows for pacemakers and ICDs, including alert triage and follow-up intervals

Identify psychosocial and lifestyle education needs (activity, driving restrictions, dietary interactions, support resources) for arrhythmia patients

Apply infection-prevention and radiation-safety practices specific to the EP/cath lab to described scenarios

Outline quality metrics and reporting expectations relevant to arrhythmia care and device follow-up

Identify scope-of-practice, documentation, and informed-consent responsibilities in the arrhythmia care setting

Evaluate monitoring-alarm fatigue and artifact-reduction strategies on a described telemetry unit

Complete timed mixed-domain practice sets and log every missed item by domain and error type

Re-teach the three weakest concepts from memory without notes and verify against source material

Interpret a fresh set of 30 rhythm strips at target speed with 90% or better accuracy

Consolidate a one-page high-yield summary of mechanisms, drug classes, and device modes for final review