EHRA Online Invasive Cardiac Electrophysiology (EP) Certification Exam

What Is the EHRA Certification in Invasive Cardiac Electrophysiology?

The EHRA EP certification is run by the European Heart Rhythm Association, part of the European Society of Cardiology (ESC). It recognises physicians who have both the theoretical knowledge and the hands-on procedural experience to practise invasive cardiac electrophysiology to a European standard.

It’s a two-step process. First you pass a demanding written exam. Then you submit a logbook proving you’ve performed a defined mix of EP procedures. Pass both and you’re certified for ten years.

EHRA EP Exam at a Glance

The Logbook Requirement

After passing the exam, you have two years to submit a logbook with an endorsement letter from your National Cardiac Society or Working Group, a supervisor’s letter and a list of 200 EP procedures. Minimums include 50 AF ablations, 25 CTI ablations for typical flutter, 15 AVNRT and 15 accessory pathway cases, 10 non-CTI atrial tachycardias, 10 diagnostic EP studies, 5 AV node ablations, and 5 VT/PVC ablations each in normal and structural hearts. Cases must fall within a 36-month window around the exam date.

What Does the Exam Cover?

• Cardiac anatomy and electrophysiology basics, including intracardiac signals and pacing manoeuvres
• Supraventricular tachycardias: AVNRT, accessory pathways and atrial tachycardias
• Atrial flutter and atrial fibrillation ablation, including mapping systems
• Ventricular arrhythmias in normal and structurally abnormal hearts
• Complications, anticoagulation and periprocedural management
• ESC guidelines relevant to arrhythmia management

How to Prepare

1. Work through tracings daily. Most questions start with an EGM or ECG; speed at reading them matters.
2. Know the ESC guidelines. Many “best answer” choices hinge on current recommendations.
3. Review EHRA’s sample questions to get used to the clinical-scenario style.
4. Consider an EHRA preparatory course in the months before the exam.
5. Do timed blocks of 65 questions to build stamina for two three-hour sessions.

A 12-Week Study Plan

Weeks 1–4: Basic EP, pacing manoeuvres and SVT mechanisms. Weeks 5–8: Flutter, AF and mapping technology. Weeks 9–10: Ventricular arrhythmias and complications. Weeks 11–12: Guidelines review and full-length timed practice.

Common Mistakes

• Studying theory without enough tracing practice
• Missing the logbook deadline after passing the exam
• Logging the same patient twice or including identifiable data

From Exam to Full Certification

EHRA’s physician certification in invasive electrophysiology works in two levels. Level 1 is the online multiple-choice exam, taken with remote proctoring on a set date that ESC publishes each year. Level 2 is your logbook of practical EP procedures, which you submit after passing. You’re only certified once both are complete, so start documenting cases early rather than reconstructing them later.

Questions follow the EHRA Core Curriculum for electrophysiology. Pair it with current ESC guidelines on arrhythmias, and practise reading intracardiac tracings. Many candidates find the tracing-based questions the most time-consuming, because they test interpretation rather than recall. EHRA reports an average success rate of around 62% for the EP exam over its history, which shows how demanding it is.

Allied Professional Option

If you’re a nurse, technician or physiologist rather than a physician, EHRA runs a separate EP certification for allied professionals. It’s exam-only and valid for 10 years.

Related Electrophysiology Practice Exams

• EHRA Cardiac Pacing and ICD (CP)
• Certified Electrophysiology Specialist (CEPS)

What’s in the CertsArea Practice Pack?

• 300 clinical-style practice questions with explanations
• PDF plus practice test software for Windows, Mac and mobile
• Free updates for 180 days and instant download

Device specialists may also want our EHRA Cardiac Pacing and ICDs practice exam.

Frequently Asked Questions

How many questions are on the EHRA EP exam?

130 questions in two parts, with 120 used for scoring.

Is there negative marking?

No.

How long is the certification valid?

Ten years.

When must I submit the logbook?

Within two years of receiving your exam result.

How many procedures do I need?

200 EP procedures, including set minimums for each procedure type.

Can allied professionals take this exam?

EHRA runs a separate EP certification for allied professionals.

Is there an EHRA EP certification for allied professionals?

Yes. EHRA’s EP/AP programme is exam-only and valid for 10 years before you must retake it.

How is the EHRA EP exam delivered?

Online, on a published exam date, with remote proctoring.