RCES case studies
RCES · Put your knowledge to work in context.
The Registered Cardiac Electrophysiology Specialist (RCES) is one of the credentials administered by Cardiovascular Credentialing International (CCI), a credentialing body for cardiovascular professionals. RCES appears in CCI's credential menu alongside related offerings such as the Certified Rhythm Analysis Technician (CRAT), Registered Cardiovascular Invasive Specialist (RCIS), and Registered Cardiac Sonographer (RCS). The RCES case studies are 5 cases and about 3,043 words.
1Long RP Tachycardia in a Structurally Normal Heart: Which Circuit?
A 45-year-old woman with a structurally normal heart (EF 60%) has had disabling palpitations for 3 years. During an EP study, a narrow-complex tachycardia at 150 bpm (cycle length 400 ms) is induced with atrial pacing.
541 words, about 3 min2All Channels Noisy and a 38-Ohm Reading Mid-Case
A 62-year-old man is undergoing an EP study with a planned ablation for SVT. Decapolar and quadripolar catheters sit in the CS and RV apex, and the baseline study has been unremarkable, with diagnostic catheter impedances of 110-140 ohms.
513 words, about 3 min3Steam Pop During Cavotricuspid Isthmus Ablation
A 66-year-old man with recurrent typical atrial flutter (EF 55%, INR 2.4 on warfarin) is under conscious sedation. An 8-mm non-irrigated tip catheter is positioned in the cavotricuspid isthmus, and RF is begun at 50 W with a 60 C target; baseline impedance is 108 ohms.
663 words, about 3 min4Three Shocks While Gardening: Reading the Lead Data
A 68-year-old man with ischemic cardiomyopathy (EF 32%) and a dual-chamber ICD implanted 4 years ago for secondary prevention received three shocks while gardening, with no preceding palpitations or syncope. Interrogation shows a VF detection rate of 200 bpm, and the stored ventricular electrogram during the shocked episodes shows rapid, low-amplitude, irregular signals.
697 words, about 3 min5Apnea During Sedation for Cardioversion in a Low-EF Patient
A 76-year-old woman (68 kg) with persistent AF, EF 30%, and CrCl 34 mL/min is on amiodarone 200 mg daily, apixaban, and furosemide. She presents for an elective TEE-guided cardioversion.
629 words, about 3 min