RCES study guide
RCES · Work through your exam, one topic at a time.
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 study guide has 7 sections and about 2,141 words.
01Cardiac Anatomy, Physiology, and Electrophysiology
The normal impulse starts in the SA node (upper right atrium, supplied by the RCA in ~60% of people), spreads through atrial myocardium, and reaches the AV node within the triangle of Koch. That triangle is bounded by the tendon of Todaro, the coronary sinus ostium, and the tricuspid annulus - a favorite identification question.
334 words, about 2 min02Electrophysiology Equipment, Instrumentation, and Basic Principles
Intracardiac signals are tiny (microvolts to millivolts) and ride on large common-mode noise, so the recording system uses differential amplifiers with high common-mode rejection. Gain (mm/mV) controls display size, not the underlying signal.
309 words, about 2 min03Diagnostic Electrophysiology Studies and Intracardiac Electrograms
At the start of a study, measure PA, AH, and HV. Normal AH is roughly 60–125 ms and reflects AV nodal conduction; normal HV is roughly 35–55 ms and reflects His-Purkinje conduction.
311 words, about 2 min04Catheter Ablation Procedures
Radiofrequency ablation heats tissue resistively near the electrode tip; lesion size grows with power, temperature, contact force, duration, tip size, and irrigation. Irrigated tips allow higher power without coagulum but reduce the temperature feedback's usefulness, so impedance drop and electrogram attenuation become the practical endpoints.
290 words, about 1 min05Cardiac Implantable Electronic Devices (Pacemakers, ICDs, and CRT)
The NBG code describes chamber paced, chamber sensed, response (I/T/D), and rate modulation. VVI paces and senses the ventricle and inhibits on a sensed event; DDD tracks the atrium and paces the ventricle when needed.
297 words, about 1 min06Pharmacology and Sedation/Analgesia
Moderate sedation in the EP lab commonly combines a benzodiazepine (midazolam) with an opioid (fentanyl). Midazolam is reversed with flumazenil and fentanyl with naloxone; both antidotes are short-acting, so continued monitoring is mandatory because resedation can occur.
296 words, about 1 min07Patient Care, Safety, and Professional Practice
Verify informed consent, allergies, anticoagulation status, and prior device history. Perform a formal time-out with the team: patient identity, procedure, site, and any implants.
304 words, about 2 min