EHRA Certification process

Katja ZeppenfeldChair Certification Committee

High-quality healthcare is a priority issue for European citizens

Right to healthcare is recognized in the Charter of Fundamental Rights of the EU

Political & Social Frame

European Community

ESC/EHRA National and Affiliated Societies

88 Countries

Wide disparity in size, wealth, political and health care systems

Different languages

Treating the same diseases

Working according to the same guidelines

Provide optimal quality in healthcare

Mission Statement

"Assure the Optimal Quality in Arrhythmia

Healthcare by Assessing the Competence in

Knowledge, Skills and Attitudes of

Professionals, Allied Professionals and

Institutions"

EHRA Certification Committee

Certification committee 2011/2013Chair Dr K Zeppenfeld The Netherlands

Vice-Chairman Dr J Cosedis Nielsen Denmark

Co-Chairman EP Physician Dr C Piorkowski Germany

Members Dr C Carbucicchio ItalyDr M Earley United KingdomDr M Hocini FranceDr P Peichl Czech RepublikDr H Tanner Switzerland

Co-Chairman CP Physician Prof J-C Deharo France

Members Dr M G Bongiorni ItalyDr C. Linde SwedenDr A Rozkovec United KingdomDr S Tzeis GreeceProf S Willems Germany

Co-Chairman CP/EP AP Dr Nick Linker United KingdomMembers Dr G. Botto Italy

Prof A. Oto TurkeyDr M Ortiz SpainDr D J Wright United KingdomMr J Elders The NetherlandsMrs C Joyce United KingdomMr P Nolan IrelandDr R Salguero Bodes SpainAsst Prof D Theuns The Netherlands

EHRA Certification of professional excellence

Heart Rhythm Specialist

Cardiac ElectrophysiologyPhysician

Heart Rhythm Specialist

Rhythm Device therapy Physician

Heart Rhythm Specialist

Cardiac ElectrophysiologyAllied Professionals

Heart Rhythm Specialist

Rhythm Device therapy Allied Professionals

EHRSEP

EHRSCP

EHRSAPEP

EHRSAPCP

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Physician

Allied Professionals

EHRA Certification of professional excellence

Theoretical Practical Documents

Theoretical Practical Documents

Theoretical Documents

Theoretical Documents

Practical

Practical

Theoretical

Part

Practical

Part

Practical

Part

Documents

Logbook I

Logbook II

Written exam

Heart Rhythm Specialist: Rhythm Device Therapy Physician

50 EPS and 35

standard ablations

150 device follow-up 50 EPS and

35 standard ablations

130 MCQ

2x3h

English

50 EPS and 35

standard ablations

150 device follow-up(logI+II100 high energy devices and 50 CRTs)

100 device implantations(at least 25 ICDs and 30 CRTs)

Maximum 3 years

CertificationEHRSCP

50 EPS and 35

standard ablations

E-logbook

Cardiologist title

Letter of Endorsement from the NS

Letter of support from Supervisor

Theoretical

Part

Practical

Part

Practical

Part

Documents

Logbook I

Logbook II

Written exam

Heart Rhythm Specialist: Cardiac Electrophysiology Physician

50 EPS and 35

standard ablations

50 EPS +

35 standard ablations1

1His, AVNRT, AVRT, RVOT VA, CTI flutter, RA Atach

50 EPS and 35

standard ablations

130 MCQ

2x3h

English

2 atrial fibrillation, LA tachycardia, VT in structural heart disease

50 EPS and 35

standard ablations

50 EPS +

15 standard ablations1+

50 complex ablation2

(at least 30 atrial fibrillation)

Maximum 3 years

CertificationEHRSEP

50 EPS and 35

standard ablations

E-logbook

Cardiologist title

Letter of Endorsement from the NS

Letter of support from Supervisor

Theoretical

Part

Documents

Written exam

Heart Rhythm Specialist: Rhythm Device Therapy AP

50 EPS and 35

standard ablations

130 MCQ

2x3h

New! 5

languages1

CertificationEHRSAPCP

50 EPS and 35

standard ablations

Letter of Endorsement from the NS/ nursing society

Letter of support from Supervisor/MD

Practical

Part

LogbookCase

studies

1English, German, Spanish, French, Italian

Theoretical

Part

Documents

Written exam

Heart Rhythm Specialist: Cardiac Electrophysiology AP

50 EPS and 35

standard ablations

130 MCQ

2x3h

English

CertificationEHRSAPCP

50 EPS and 35

standard ablations

Letter of Endorsement from the NS/ nursing society

Letter of support from Supervisor/MD

Practical

Part

LogbookCase

studies

Comming soon..

E-learning tract AP

E-learning tract basic EP/CP

E-self assessment (MCQ)Completion of the E-learning course and successful assessment will result in a “certification of participation”

No requirement to register for the written exam

Accreditation of training centres

General requirements

I

Full service cardiology/cardiac surgery

Training centre cardiology

Nationally recognized centre licensed to perform all arrhythmia/device procedures1

1Exception lead extractions, arrhythmia surgery, GUCH

General requirements

II

≥1 dedicated lab EP/CP≥ 2 recognized EHRA CP/EP specialists

Recording procedural data

Recording complications

Active training progam

Program supervisor

Procedures

Recognized EHRA CP/EP specialistEHRA member

≥ 7 years of experience EP/CP

Performing ≥ 100ablations/35 implantations/year as main operator

CP≥ 50 CRTD/-Ps≥ 50 ICDs≥ 100 PM

EP≥ 250 EPS≥ 200 standard ablations≥ 100 LA ablations

Advanced

Application form

Letter of Endorsement from the NS

Documents

EHRA accrediated trainings centre advanced EP/CP

Accreditation of training centres

General requirements

I

Full service cardiology1

Involved in training for cardiology

Nationally recognized centre licensed to perform arrhythmia/device procedures

1no cardiac surgery required 2may be CP or EP but at least one CP for CP training and one EP for EP training

General requirements

II

≥2 recognized EHRA CP or EP specialists2

EHRA member

Recording procedural data

Recording complications

Active training progam

Procedures

CP≥ 100 PM/year

EP≥ 100 EPS≥ 50 ablations

Basic: Basic training centres should not be the sole training centre and should co-operate with an advanced training centre

Documents

Application form

Letter of Endorsement from the NS

EHRA accrediated trainings centre basic EP/CP

EHRA Certification since 2005Ar

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Croa

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Fran

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Gre

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Ger

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Hun

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Ital

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Iran

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Nor

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Pola

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Russ

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Spai

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Tche

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Rep.

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Turk

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Switz

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Ukr

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EPEuropace 05 1 1 1 (1) 16 (2) 1 (1) 20WCC 06 1 (1) 5 (2) 1 (1) 1 (1) 3 (2) 1 (1) 1 4 (1) 17Europace 07 1 (1) 1 1 2 (2) 1 1 (1) 1 4 (1) 1 1 (1) 3 (1) 1 6 (1) 1 (1) 1 2 1 29Cardiostim 08 2 (1) 1 2 (2) 4 (3) 6 (1) 1 (1) 6 (5) 1 (1) 1 5 (1) 2 (1) 5 (2) 2 (1) 1 1 9 (4) 49Europace 09 1 2 (1) 3 (2) 2 (2) 3 (2) 4 (2) 1 (1) 7 (4) 5 (2) 9 (6) 1 7 (5) 1 (1) 3 1 1 10 (4) 2 (2) 1 (1) 2 (1) 8 (6) 74Cardiostim 2010 5 (2) 5 (3) 2 (1) 1 (1) 7 (3) 1 (1) 12 (9) 3 7 (5) 1 (1) 4 (3) 2 1 (1) 1 14 (2) 1 2 (2) 1 1 2 (1) 2 11 (4) 86EHRA Europace 2011 3 4 1 3 1 1 1 7 1 2 18 1 12 7 5 1 2 13 1 2 1 1 8 96TOTAL PER COUNTRY EP 1 12 (4) 13 (6) 1 4 3 (1) 1 4 (3) 1 19 (7) 12 (8) 2 (1) 45 (16) 11(3) 43 (19) 2 (1) 1 (1) 2 1 (1) 3 (2) 25 (11) 1 (1) 17 (3) 4 (1) 3 (1) 1 2 68 (12) 6 (4) 5 (3) 2 (1) 5 (1) 2 2 (1) 4 37 (14) 368 (125)

Europace 05 1 2 1 2 5 1 (1) 1 1 (1) 14WCC 06 1 7 (1) 1 11 (2) 1 (1) 5 4 2 1 (1) 1 34Europace 07 1 1 1 4 1 3 (1) 1 17 (3) 1 2 7 1 1 4 (2) 1 1 (1) 1 3 51Cardiostim 08 3 (1) 4 (1) 2 (1) 1 1 3 (1) 7 2 7 (1) 1 17 (4) 3 2 (1) 1 2 6 (1) 1 (1) 1 (1) 1 1 (1) 8 (3) 74Europace 09 1 1 (1) 1 1 5 (1) 3 (2) 3 4 8 (1) 38 (7) 2 2 1 5 3 1 4 1 (1) 7 (2) 91Cardiostim 2010 1 3 3 1 (1) 3 (1) 2 2 (2) 6 (2) 3 (3) 5 (1) 1 8 (3) 45(21) 1 (1) 4 (1) 2 (1) 5 (4) 13 (1) 5 (2) 4 (2) 1 4 2 (1) 6 (1) 131EHRA Europace 2011 4 8 1 2 2 3 7 1 13 1 8 1 45 1 3 1 1 1 8 3 4 1 7 2 1 7 136TOTAL PER COUNTRY CP 1 11 (1) 16 (1) 2 (2) 1 9 (2) 4 4 (2) 1 1 15 (3) 28 (7) 1 30 (1) 8 47 (8) 3 (1) 2 167 (35) 8 (1) 15 (1) 4 (2) 6 5 (4) 2 34 (2) 21 (3) 12 (3) 5 (2) 18 3 5 (3) 2 (1) 4(3) 8 (1) 26 (5) 531 (94)

EHRA Europace 2011 1 1 28 2 1 1 34TOTAL PER COUNTRY* 1 1 23(5) 30 (7) 2 (2) 2 13 (2) 7 (1) 5 (2) 5 (3) 2 34 (10) 40 (15) 3 (1) 75 (17) 19 (3) 90 (27) 5 (2) 1 (1) 4 1 (1) 3 (2) 220(46) 9(2) 32 (4) 4 (1) 10 (1) 8 (4) 1 4 104 (14) 27 (7) 17 (6) 7 (3) 24 (1) 5 5 (3) 2 (1) 6 (4) 1 12 (1) 63 (15) 933 (219)

EP

CP

AP

Candidates from 43 countries!

20 17

29 49

74 86

96 368 (125)

14 34

51 74

91 131

136 531 (94)

34 933 (219)

Countries where IBHRE formerly NASPEexAM recipients are located

Cardiac Rhythm Device Therapy for the Physician (since 1985)Cardiac Electrophysiology for the Allied Professional (since 1987)Cardiac Rhythm Device Therapy for the Allied Professional (since 1988, Japan 2008)Cardiac Electrophysiology for the Physician (december 2011)

Certification Rhythm device therapy Physician: IBHRE (formerly NASPEexAM) vs EHRA

17

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198

48

99

31

126

38

102

31

00

206

62

00

126

31

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136

46

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107

24

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75

17

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65

9

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130

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117

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123

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154

43

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168

58

73

119

32

91

104

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131136

0

50

100

150

200

250

1985 1988 1991 1994 1997 2000 2003 2006 2009

Total USFail USTotal EHRAFail EHRA

EHRA Certification

CP Physician EP Physician

Expected in 2012: 699 Expected in 2012: 486

Total number of physicians in 8 years: 1185!

Planning the future

• Keeping the high standard

• Increasing the number and quality of MCQs

• Development of a computer based exam

• Offering the exams during the annual meetings of the NS and WG

• Involve more Physicians and Allied Professionals in the EHRA certification of excellence

Best practice and latest treatment for heart rhythm disorders