FAQs

NASPExAM was created in the mid-1980s because physicians and allied professionals had no method of becoming board certified for electrophysiology, and those certifications that did exist, nor was there a way to clearly define the electrophysiological expertise associated with devices This fueled the development of an exam that would exclusively measure the core competency, skills and credibility of health care professionals involved in cardiac pacing and cardioversion defibrillation.

The concept for a pacing exam began in 1984. Established in 1985, the International Board of Heart Rhythm Examiners provides certification in the fields of cardiac rhythm device therapy and cardiac electrophysiology; certification is offered to physicians and allied professionals. Successful completion of an IBHRE examination certifies that a practitioner has met standards for recommended knowledge and patient care

IBHRE certification is accorded to those physicians and allied professionals who have successfully passed the rigorous IBHRE Exam. Recipients of IBHRE certification are professionally competent, highly respected by peers and other medical professionals, can demonstrate advanced skills in clinical practices and represent a standard of excellence in the arrhythmia community.

The IBHRE exams are designed for: 

• Physicians (e.g., cardiology, pediatrics, internal medicine, cardiovascular diseases, general surgery, thoracic surgery, emergency medicine, and anesthesiology)  
• Allied professionals (e.g., nurses, physician assistants, EP/lab techs, technologists, engineers) employed in the field of cardiac pacing and/or electrophysiology. 

Exam Eligibility Policies

If you are a heart rhythm health care professional in the clinical or industry setting responsible for the management of patients with cardiac rhythm disorders, you should take the IBHRE exam. The exam addresses the knowledge required for physicians and allied professionals tasked with specific technology-based interventions and therapies to patients undergoing invasive and noninvasive diagnostic, therapeutic and surgical procedures in cardiac pacing, defibrillation and electrophysiology. 

Yes. IBHRE requires specific education, training or work experience to take the exams. Upon application, all candidates are required to provide current and accurate statistical data regarding their past training and present involvement in the field.

Exam Eligibility Policies

• Certified Cardiac Device Specialist (CCDS) – Physician

• Certified Cardiac Device Specialist (CCDS) – Allied Professional

• Certified Cardiac Device Specialist - Japan Device Representative (CCDS-JDR) - Allied Professional

• Certified Electrophysiology Specialist – Physician

  • Adult (CEPS-A)

  • Pediatric (CEPS-P)

• Certified Electrophysiology Specialist (CEPS) – Allied Professional

• Cardiac Device Remote Monitoring Specialist (CDRMS) - Allied Professional

Each IBHRE certification examination is offered annually during a pre-determined testing window. All IBHRE exams are offered through computer-based testing at PSI Test Centers throughout North America and internationally. 

Please see the chart below for the number of items (questions) and exam breaks.

IMPORTANT NOTE: Following completion of each section you may not return to a previous section. There is a hard time-limit allocated to each section.

All interested applicants must submit a completed application, provide documentation of eligibility and pay the applicable exam fees by the registration deadline in order to be approved to take the exam. To apply for the exam, click on the appropriate link below visit to review the eligibility requirements and access the online application:

• Certified Cardiac Device Specialist (CCDS) Exam for the Physician

• Certified Cardiac Device Specialist (CCDS) Exam for the Allied Professional

• Certified Electrophysiology Specialist in Adult or Pediatric (CEPS-A or CEPS-P) Exam for the Physician

• Certified Electrophysiology Specialist (CEPS) Exam for the Allied Professional

• Cardiac Device Remote Monitoring Specialist (CDRMS) - Allied Professional

• Certified Cardiac Device Specialist - Japan Device Representative (CCDS-JDR) Exam for the Allied Professional

The deadline for application submission will vary depending on the exam date. IBHRE must receive your application by the application deadline.  Contact IBHRE at [email protected]  if you experience issues during the online registration process.

Once your application has been approved, you will receive a formal confirmation and receipt via e-mail. The confirmation letter only confirms the approval of your application and your eligibility to take the exam. It does not confirm that you have scheduled an exam appointment.

Exam fees vary depending on which exam a candidate is planning to take. Each exam offers a discounted rate for applicants who apply by the early registration deadline. A discount is also offered to current members of the Heart Rhythm Society, except to those taking the Physician EP Exam. Click on the appropriate link below to view the complete fee schedule and relevant policies. Note: IBHRE reserves the right to increase fees.

• Certified Cardiac Device Specialist (CCDS) Exam for the Physician 

• Certified Cardiac Device Specialist (CCDS) Exam for the Allied Professional

• Certified Electrophysiology Specialist - Adult or Pediatric (CEPS-A or CEPS-P) Exam for the Physician

• Certified Electrophysiology Specialist Exam for the Allied Professional

• Cardiac Device Remote Monitoring Specialist (CDRMS) - Allied Professional

• Certified Cardiac Device Specialist - Japan Device Representative (CCDS-JDR) Exam for the Allied Professional 

Applicants interested in the CCDS-JDR exam should contact the Secretariat of the Japan CDR Center  for more information.

The exam fees charged by IBHRE cover a candidate’s application fee, examination appointment at an authorized testing center, test development, exam assessment, scoring, the candidate’s certification pin and certificate (if applicable), and other administrative and overhead costs related to administering the exam.

Note: All exam candidates are responsible for covering the cost of their own study materials and the cost of travel to a test center. Some special requests such as replacement of a certification pin or certificate be subject to an additional fee.

No. Membership with the Heart Rhythm Society is not required to take the exam. Current members of the Heart Rhythm Society do qualify for a special discount on exam fees, except for the Physician EP Exam, but no additional preferential treatment is given.

No. HRS membership must be current on the date of application in order to be eligible to receive a discount. Non-members interested in receiving this discount must submit their membership application and dues, and be approved, prior to submitting their exam application.

Candidates who require special accommodations will have the opportunity to submit a request during the active scheduling period for their exam. Once received and approved by the testing agency, candidate will receive direct contact from them to assist with scheduling an exam appointment. 

In the event that you need to cancel your exam registration, you will need to submit a written request to IBHRE providing the following information:

• Your name
• Date and title of the exam you are registered for
• Reason for withdrawing from the exam

Cancellation requests may be submitted to IBHRE by e-mail. IBHRE will only honor requests submitted by exam candidates and will not recognize cancellation requests submitted by third parties. Refunds are issued directly to the party that submitted initial payment. Be sure to review the Cancellation and Refund Policy prior to applying for the exam.

About 12-15 weeks after the exam registration closes, candidates will receive emailed instructions for scheduling an appointment online. Visit the Steps to Certification page, #4 to learn specifics on scheduling an appointment.

The best way to locate a test center by state/province or country is to visit PSI Test Taker Support link.

In some cases, candidates will not have immediate access to a Test Center. In those situations, some travel may be necessary on the part of the candidate at their expense. Be sure to consider a second and third choice test center in case your first choice is unavailable on exam day. 

Exam appointments are given out on a first-come-first-served basis so be sure to schedule your appointment at least thirty (30) days prior to the exam to ensure that you can test at your preferred test center. Test-takers from other organizations may also be attempting to schedule their exams at the same time and location as you, so it is imperative that exam appointments are made as soon as possible. If you are unable to schedule an appointment at any of the test centers in your area, contact  PSI Candidate Support immediately for further assistance.

No. Upon scheduling your appointment, you may be presented with the option of selecting your start time in which case you are free to choose whichever start time is most convenient for you. In some cases, your choice of start times may be limited and it may be necessary to accept whichever time is available.

The final cut-off date to schedule an exam appointment is two business days prior to the exam date, and even then there may be no availability at your preferred testing site. Candidates who attempt to schedule within two days of the exam will not be permitted to schedule an appointment.

IBHRE strongly recommends that you schedule your exam appointment at least thirty (30) days prior to the exam. After 30 days prior to the exam, IBHRE cannot guarantee that an exam appointment will be available at your preferred testing location(s). You may seek assistance from IBHRE when scheduling an appointment until three weeks prior to the exam. If you do not schedule your appointment within three weeks of the exam, IBHRE cannot guarantee assistance with securing a location and cancellation penalties will be enforced.

No. If you need to cancel your exam appointment less than two weeks prior to the exam, regardless of reason, you will not receive any refund pursuant to the timeline stipulated in the IBHRE Cancellation and Refund Policy . IBHRE will strive to provide reasonable assistance to any candidate experiencing difficulty with the scheduling process as long as the candidate provides notice of the situation at least two weeks prior to the exam.

Please note: Candidates must first cancel their appointment through the scheduling portal up to two weeks before the exam then contact IBHRE to notify us of the withdrawal request. See IBHRE Cancellation and Refund Policy for more information.

The length of time depends on your budget, schedule, and the urgency you personally feel about passing the exam. Candidates often draw from their previous education and professional experience, IBHRE recommended readings, and the exam content outline to develop their own study plan to prepare for the exam.

Refer to IBHRE's Exam Resources page. 

There are no course requirements for taking the exam.

Please visit this page for more information. A tutorial will also be available to all candidates during the first 15 minutes of their exam. IBHRE strongly recommends that you take time to review this tutorial before exam day.

You should plan to arrive at your testing center 30 minutes prior to your start time to allow adequate time to be signed in by the Testing Center Administrator. If you are more than 30 minutes late for your appointment, you will not be permitted to test.

For all exams - An unexpired Government Issued Photo ID is required. Check your appointment confirmation to ensure that the first and last names on your confirmation and the first and last names on your ID are the same.*

*If you find that your names do not match, you must contact IBHRE at least two weeks prior to the exam to obtain a new permit.

You may bring personal items such as cell phones, purses, and food to the testing center but you may not carry those items into the testing room. The Test Center Administrator will provide you with a locker to store your personal belongings while you are testing. For a complete list of the Test Center Rules and Regulations, be sure to review the Computer-Based testing section of this website. 

No. Any outside paper or writing instrument is strictly forbidden in the testing room.

No. The testing software for IBHRE exams is equipped, as determined by test writing committee members, with electronic calculators and calipers which you may use throughout the exam.  

Yes. You may bring soft earplugs to use during the exam. The Test Center Administrator must inspect earplugs before you enter the testing room. You may also request noise-blocking headphones at the testing site.

Candidates should seek prior approval from IBHRE to use a magnifying glass during the exam. The Test Center Administrator will permit candidates with prior approval to bring their own magnifying glass into the testing room upon inspection.

As soon as the Test Center Administrator signs you into your computer, your exam will officially begin.

Every exam candidate is allotted five hours for the entire exam session. All examinees can review past questions, but may not return to a section once it is complete. Once an examinee has completed a section, they may proceed to the next section or take a scheduled break. Refer to the exam content outline/blueprint in this handbook.

Examinees are given the opportunity to take an optional Computer-Based Testing (CBT) tutorial prior to the exam and optional break time. Any unused time remaining from the CBT tutorial may be used as optional break time throughout the scheduled exam appointment. Computer experience is not necessary to use CBT.

As you complete the exam, the amount of time you have remaining is provided in the upper-right corner of each screen. Any delays, such as the loading of the next screen, will not be counted against your exam time. Note: The test will automatically end if you run out of time.

Please see Candidate Handbook.

Yes. A break taken while a test block is still open is called an ‘unauthorized break’. While you are allowed to take unauthorized break time, it is not recommended. Be aware that if you use unauthorized break time, the break time will be deducted directly from your testing time and you will run a risk of not being able to answer all of the questions in the block before time runs out.

Once you have answered all of the questions, you will have the option of taking an exit survey. This survey provides IBHRE with valuable feedback that helps us further develop and improve our examination process. After you have finished the survey, you will receive a printout from the test center indicating that you completed the exam. Once you receive your printout you may leave the test center. Before exiting the testing room, be sure to return any laminated paper or dry erase markers you may have been given to the Test Center Administrator.

Maybe. Test Center Administrators are employed by Prometric to check-in candidates, sign them into their exams, monitor the exam room for irregularities and cheating behavior, address technical issues, and submit problem reports if necessary. Prometric employees are not equipped with substantive information about the IBHRE exam or the IBHRE certification process and may not be able to answer every question you may have on exam day. If there is a question that a Test Center Administrator cannot answer, please contact IBHRE at 202-464-3414.

Be sure to report any technical or environmental issues that you experience to your Test Center Administrator. They will be responsible for filing a problem report on your behalf. Problem reports are submitted to those responsible for scoring the exams for consideration. In addition, IBHRE reviews all problem reports to identify any recurring issues that may need to be addressed.

You should first be sure to report any issues before leaving the testing center by completing the post-exam survey. If you have any questions, concerns or complaints regarding your exam experience you must contact IBHRE by e-mail at [email protected] within one week (7 days) of the exam to be given due consideration. IBHRE will investigate any complaints received and will provide a prompt response.

Download the IBHRE Complaint Form

As a global leader in cardiac rhythm device therapy and electrophysiology certification, IBHRE is pursuing international partnerships to maintain a diverse and high level of expertise among cardiac care professionals worldwide and advance the heart rhythm profession by meeting the specific credentialing needs of other health care systems. It is the vision of IBHRE to work towards a global standardization of cardiac rhythm management by establishing a measure of competence among health care professionals in order to provide an acceptable level of care for the arrhythmia patient.

IBHRE’s Physician EP exam is designed specifically to help standardize knowledge for international and pediatric physicians who are qualified by their training or experience to take such an exam, but are not board eligible for the American Board of Internal Medicine (ABIM) exam in electrophysiology. ABIM requires that the physician must be U.S. Board Certified in both Internal Medicine and Cardiovascular Medicine. Many physicians in the U.S. have received a portion or all of their training outside the U.S. and are therefore not eligible for the ABIM exam. Additionally, many physicians in countries such as Canada, Australia, China, India, Japan, and the Middle East would like to be Board Certified in EP, but do not meet the U.S. requirements. Pediatric electrophysiologists in the U.S. have no route to EP board certification beyond the Pediatric Cardiology Sub-Board examination of the American Board of Pediatrics. IBHRE developed the Physician EP exam specifically to fill this gap of knowledge in EP certification.

Over the last 15 years, IBHRE has seen the number and diversity of its international certified professionals increase exponentially, with certification recipients from more than 45 countries (see statistical data here). IBHRE is well positioned to assist countries with the development of pacing and EP certification programs to standardize optimal health care practices, safeguard patient care and certify knowledge. IBHRE already has a track-record of cooperative partnerships with international organizations, most notably the Japanese Heart Rhythm Society.

The Japanese Ministry of Health stipulated that all professionals in the medical device industry who have direct contact with cardiac patients must be nationally certified, yet there was no certification mechanism in place. Traditionally, IBHRE addresses the needs of Western cardiac rhythm management standards, but the IBHRE representatives stepped in to help create a specifically tailored examination to meet the Japanese Ministry of Health’s requirements. The IBHRE exam that was created was then translated into Japanese, customized and administered to Japanese allied professionals by computer-based testing. The questions on this exam are based upon a job task analysis study that reflects Japanese customs and practices.

IBHRE understands that different health care systems have different standards, certification requirements, and needs. Therefore, IBHRE is committed to tailoring examinations to national health care systems’ needs while maintaining an international standard of excellence among cardiac rhythm management professionals. International applicants can elect to take any of IBHRE’s given exams or have their organizations partner with IBHRE to tailor and deliver the exam in their preferred language. Additionally, given international variations in training and educational requirements, IBHRE evaluates qualification criteria for its exams on a country-by-country basis to make sure that those who have the training and expertise can also have the certification.

Please contact Tracy Lofty, Executive Director of IBHRE who would be happy to explore the option further at [email protected].

Candidates will receive emailed instructions for retrieving score reports approximately 12 weeks after the exam period ends. Once the scores have been submitted to IBHRE by the psychometrician, the names of those who passed the exam will be posted to the web site and candidates will be notified via email accordingly. In addition, those who passed will receive emailed instructions for issuance of official certificate.

Because the overall difficulty of the test varies slightly from year to year, total scores are equated so that a score of "500" on one exam represents the same level of proficiency as a score of "500" on a previous test form. The number of correct answers required to pass is not reported because it varies slightly from administration to administration, year to year (and from each form).

The "cut score" is determined psychometrically from the standard setting exercise. In doing this, IBHRE comes to consensus as to what percent of the time a minimally qualified candidate would get each individual question correct. These data are used to generate a minimal passing score on the exam. Any candidate scoring at or above this level will pass. It is then theoretically possible for all candidates to pass, and likewise to fail. We do not use an arbitrary passing score, nor do we curve the exam so that a specific number of people will pass or fail. In doing this, and by equating exams year after year, we are able to keep the level of knowledge needed to pass the exam equivalent each year. The standard setting exercise is done once every five (5) years at a minimum, and for each physician electrophysiology exam administration as the number of candidates taking the exam is small such that we do this to maintain integrity of the cut score.

Content experts review a variety of statistical analyses before setting a pass/fail standard. The equating procedure allows IBHRE to require the same level of proficiency across years and this means that the pass/failure rates vary somewhat across administrations. You may refer to the statistics page for more information.

Upon passing the exam, you will be considered IBHRE certified in the field pertaining to your exam for a total of ten years. You will receive a certificate confirming this accomplishment and your name will be added to the IBHRE website.

Once you achieve IBHRE certification, you may experience one of many benefits such as:

• Recognition from your peers as a highly qualified physician or allied professional within the heart rhythm management field 
• Qualification for advancement in your current position 
• Competitive advantage for jobs that may require IBHRE certification 
• Validation that you have acquired knowledge essential to the practice of heart rhythm management. 

If you do not pass the exam, you will receive a score report that provides key-word feedback pertaining to the areas of the exam where you did not perform well. This report is intended to help candidates identify areas that may require additional study. 

Candidates who do not pass the exam are greatly encouraged to take the exam again. There is no limit on the number of times a candidate may re-take an examination.

Continuing Medical Education credits are not offered for passing the exam.

With over 25 years of history in arrhythmia testing, IBHRE offers unique certifications designed to demonstrate a mastery of knowledge in cardiac rhythm management. In late 2011, IBHRE introduced the first certification through the Board Certification Examination for Competency in Cardiac Electrophysiology for the Physician.

The IBHRE Physician EP Exam covers a small amount of electrophysiology topics and is generally targeted at physicians who specialize in device therapy. These may or may not be electrophysiologists, and include surgeons, internists, pediatric physicians and others. The Physician EP exam evaluates knowledge and judgment in the broad domain of clinical cardiac electrophysiology and the diagnosis and treatment of patients who suffer from heart rhythm disorders. The exam bridges the difference between language and practice to meet the certification needs of international, pediatric and qualifying U.S. physicians who have chosen EP as their subspecialty practice.

Yes, however there are many physicians who want to obtain the credential for “Certified Electrophysiologist” and who are not able to take the current U.S. EP Board exam delivered by ABIM. IBHRE saw the need to develop an international examination to certify physicians in EP who are qualified by their training or experience to take such an exam, but who may not be eligible to take the ABIM exam due to training outside the U.S. or completion of a pediatric cardiology board.

1. Those who have obtained part or all of their education abroad.
   ABIM requires that the physician must be U.S. Board Certified in both Internal Medicine and Cardiovascular Medicine. Many physicians in the U.S. have received a portion or all of their Internal Medicine or Cardiovascular Medicine training outside of the U.S. and are therefore not eligible to take the U.S. ABIM EP Board Exam.
2. Pediatric Cardiologists.
   Pediatric Cardiologists with special training and expertise in cardiac electrophysiology are also not eligible to take the U.S. ABIM EP Board Exam, as it requires adult cardiology certification.
3. Physicians in other countries.
   Many physicians in countries such as Canada, Australia, China, India, Japan, and the Middle East would like to be Board Certified in EP, but they do not meet the U.S. requirements.

The Physician EP exam will help to standardize EP knowledge particularly for international physicians (and qualifying U.S. physicians) who are not board eligible for the American Board of Internal Medicine (ABIM) exam.

Currently, pediatric electrophysiologists in the U.S. have no other option of becoming board certified other than the Pediatric Cardiology Sub-Board examination of the American Board of Pediatrics. In fact, there are no third-tier examinations available for any of the subspecialties of pediatric cardiology. The IBHRE Physician EP exam is designed to provide a route to board certification for pediatric cardiologists who have completed advanced training in pediatric electrophysiology. The pediatric content for the examination was developed by an international committee of recognized experts in pediatric electrophysiology.

No. Only those physicians who do not qualify for the ABIM EP Exam are eligible to take the IBHRE exam. If you are eligible to take the ABIM exam, you should utilize that pathway to achieve Board Certification.

Applicants for the IBHRE Board Certification Examination in Cardiac Electrophysiology for the Physician must be licensed physicians with active involvement in the clinical management and care of adult or pediatric patients. Physicians must also have successfully completed training equivalent to an accredited medical school, residency and fellowship. Refer to the Physician EP Eligibility Policy for more information.

Physicians that were trained prior to the availability of EP-specific training programs (generally prior to the late 1990s) would be able to take the exam based on confirmation of appropriate exposure to EP and continued clinical practice as an EP. 

Given the international variations in training and educational requirements, IBHRE will evaluate qualification criteria on a country-by-country basis.

IBHRE offers two Physician EP exams:

1. Adult Electrophysiology
2. Pediatric Electrophysiology

Please refer to the Physician CEPS Exam Content Outline for more information.

Please refer to the Physician CEPS Exam Content Outline  for more information.

No. Physicians who qualify according to the IBHRE Eligibility Policy can only select either the Adult or Pediatric module of the EP exam. 

The Physician EP exam is currently only being administered in the English language. Prospective candidates are encouraged to have their respective organizations contact IBHRE at [email protected] to inquire about delivering the exam in their preferred language.

Currently, IBHRE certification is valid for 10 years. The year of expiration is located on the candidate’s certificate. All certified professionals must meet requirements for recertification  by December 31 of their recertification year to renew their certification by reexamination.

Effective 2022, all newly certified individuals will participate in IBHRE-C3 to maintain certification. Individuals due to recertify 2021-2031 (CCDS, CEPS, CEPS-A, CEPS-P) have the option to recertify via a comprehensive exam or IBHRE-C3. Certified professionals who do not recertify will lose their IBHRE credential. Certification validity periods are subject to change at the discretion of IBHRE.

For those with certifications that expire up to 2031 and have not enrolled in IBHRE-C3:

Five (5) years after passing the exam, certified professionals must attest to having completed 45 contact hours of professional development activities that are applicable to their IBHRE certification. Verification of continuing education  (VCE) criteria are subject to change. As of 2010, all IBHRE certified professionals are required to file a Verification of Continuing Education form and pay a processing fee by December 1 of their fifth year of certification in order to maintain their credential. 

For those with certifications that expire up to 2031 and have not enrolled in IBHRE-C3:

Ten (10) years after passing the exam, certified professionals must re-certify by re-examination . Certified professionals must also attest that they are currently active and involved in the field of cardiac rhythm management and that they remain in good standing within the medical community. Candidates who do not meet these requirements will lapse in their certification. (Effective January 1, 2010) 

Effective 2022, all newly certified individuals will participate in IBHRE-C3 to maintain certification. Individuals due to recertify 2021-2031 (CCDS, CEPS, CEPS-A, CEPS-P) have the option to recertify via a comprehensive exam or IBHRE-C3. Certified professionals who do not recertify will lose their IBHRE credential. Certification validity periods are subject to change at the discretion of IBHRE.