IBHRE CEPS study plan

Map the full EP domain blueprint into a one-page outline covering basic cellular electrophysiology, action potential phases and ionic currents, and the conduction system anatomy

Explain the ionic basis of automaticity, triggered activity, and reentry aloud without notes, then list one clinical arrhythmia example for each mechanism

Draw and label the normal intracardiac electrogram sequence (HRA, His, CS, RV) and define normal AH, HV, and sinus node recovery time values from memory

Build a 40-term flashcard deck for EP vocabulary (ERP, decremental conduction, anisotropy, gap junction, wavelength) and review it twice

Work through supraventricular tachycardia differential diagnosis using atrial and ventricular activation timing, and write the discriminating criteria for AVNRT, AVRT, and atrial tachycardia

Describe typical and atypical AVNRT slow pathway targets and the anatomic landmarks used to avoid AV block during slow pathway modification

Explain accessory pathway localization from delta wave morphology and from earliest ventricular activation during pacing

List the diagnostic pacing maneuvers (para-Hisian pacing, differential pacing, entrainment with return cycle) and state what each proves

Compare radiofrequency and cryothermal energy sources on lesion geometry, thrombus risk, and collateral injury, and state when each is preferred

Outline the step-by-step approach to typical atrial flutter ablation including the cavotricuspid isthmus, bidirectional block testing, and endpoints

Describe pulmonary vein isolation technique, antral lesion set rationale, and the evidence for ablation as first-line therapy in paroxysmal atrial fibrillation

Identify procedural safety practices for each ablation site: esophageal temperature monitoring, phrenic nerve pacing, coronary proximity, and anticoagulation strategy

Explain ventricular tachycardia substrate mapping and ablation in structural heart disease, including scar definition, voltage criteria, and when to choose substrate modification over activation mapping

Describe the indications and technique for idiopathic outflow tract and fascicular VT ablation and how outcomes differ from scar-related VT

Summarize complication recognition and management for ablation: tamponade, PV stenosis, atrioesophageal fistula, coronary injury, and stroke

List the guideline-based indications and contraindications for catheter ablation across SVT, AF, atrial flutter, and VT

Decode pacemaker and ICD codes using the NBG system and match common clinical scenarios to the correct code

Explain pacemaker timing cycles including lower rate limit, AV delay, PVARP, post-ventricular atrial refractory behavior, mode switching, and rate response

Describe ICD detection and discrimination algorithms, tiered therapy programming, and the programming choices that reduce inappropriate shocks

Compare leadless pacing, conduction system pacing, and subcutaneous ICD on indications, advantages, and limitations

Interpret device interrogation findings systematically: undersensing, oversensing, lead impedance trends, capture threshold changes, and stored electrogram review

Explain CIED infection, venous stenosis, lead failure, and Twiddler syndrome recognition and management steps

Describe MRI-conditional device requirements, remote monitoring workflow, and end-of-life battery management including deactivation discussions

State anticoagulation and periprocedural management principles for CIED implantation and extraction

Build a drug comparison table for antiarrhythmic agents covering Vaughan-Williams class, primary ion channel effect, key indications, and major adverse effects

Explain proarrhythmia risk, QT assessment, and the specific precautions for drugs used in structural heart disease versus normal hearts

Apply stroke risk scoring and anticoagulant selection for atrial fibrillation, including when to prefer a direct oral anticoagulant over warfarin

Describe acute and chronic management of hemodynamically stable versus unstable tachyarrhythmias and the role of antiarrhythmics after device therapy

Complete a full-length timed practice examination under test-day conditions and log every wrong or guessed answer by domain

Re-study only the highest-yield weak areas identified in the practice exam and rewrite those concepts in your own words

Recite the key numeric thresholds and normal values across all four domains from memory (AH, HV, QT, impedance, detection rates, anticoagulation criteria)

Review the personal error log and confirm each corrected concept is retrievable on a second pass