EHRA Online Invasive Cardiac Electrophysiology (EP): Exam and Certification Guide
The EHRA Certification in Invasive Cardiac Electrophysiology (EP) is a professional certification organized by the European Heart Rhythm Association (EHRA) for physicians with a special interest in invasive cardiac electrophysiology. The programme assesses theoretical knowledge through a written examination and practical experience through a clinical logbook.
What Is the EHRA Invasive Cardiac Electrophysiology Certification?
The EHRA EP Certification programme is designed to assess the knowledge, skills, and clinical competencies required for invasive cardiac electrophysiology practice. EHRA states that the programme is intended to establish a common standard of competency in the field across Europe and beyond.
For physicians, the certification programme has two components:
- The written examination, which evaluates theoretical knowledge.
- The logbook, which documents practical training, procedures, and clinical experience.
Candidates must complete both parts to receive the full EHRA certification in invasive cardiac electrophysiology.
It is important to note that EHRA describes the certification as non-regulatory. National laws and regulations determine whether professionals can independently perform, report, or sign clinical procedures and studies in a particular country.
Who Can Take the EHRA EP Exam?
The physician examination is open to physicians with a special interest in invasive cardiac electrophysiology. At registration, candidates are required to provide a copy of their medical diploma issued by a national health authority. EHRA recommends that candidates acquire appropriate knowledge and clinical experience before attempting the examination.
EHRA also maintains a separate EP/AP certification for allied professionals working in invasive electrophysiology. The allied-professional examination has its own eligibility and certification requirements.
Candidates should therefore confirm whether they are applying for the physician EP certification or the allied-professional EP/AP pathway.
What Is the EHRA EP Exam Format?
The EHRA EP examination is a multiple-choice written examination conducted in English. It contains 130 questions divided into two sections of 65 questions each.
Each section is allocated three hours, with a one-hour break between the sections. Questions are based on clinical scenarios and provide five answer options, with one single best answer. EHRA states that there is no negative marking.
The examination covers the full spectrum of electrophysiology represented in the EHRA Core Curriculum. This means preparation needs to extend across a broad range of clinical and technical subjects rather than concentrating on only a few procedures.
What Topics Should Candidates Study?
The EHRA EP examination is aligned with the EHRA Core Curriculum, which provides a comprehensive framework for training in cardiac electrophysiology and pacing. EHRA recommends that candidates study broadly because examination questions are not derived from one single source.
Preparation should include areas such as:
- Cardiac electrophysiology fundamentals
- Cardiac arrhythmias
- Electrophysiological mechanisms
- Intracardiac electrograms
- Electrophysiological studies
- Catheter-based procedures
- Supraventricular tachycardias
- Atrial fibrillation
- Atrial flutter
- Ventricular tachycardia
- Catheter ablation
- Mapping techniques
- Complications and procedural considerations
- Relevant clinical guidelines and evidence
The exact distribution of questions should be checked against the current EHRA examination blueprint and Core Curriculum.
How Is the Online Exam Delivered?
EHRA usually delivers the EP examination through an online proctoring platform. The online format allows candidates to take the examination from anywhere in the world using their own computer, while a human proctor monitors the examination remotely.
The current EHRA schedule lists an online English EP examination for 1 October 2027, with registration opening three months before the examination date. Registration closes 15 days before the examination or earlier if capacity is reached.
Because examination dates and registration conditions can change, candidates should verify the current schedule before making travel, preparation, or registration plans.
What Happens After Passing the Written Exam?
Passing the written examination gives the candidate access to the logbook component of the physician certification programme. The logbook is designed to demonstrate actual clinical experience in electrophysiology.
EHRA currently requires evidence of 200 EP procedures, including specified numbers of procedures such as AVNRT procedures, accessory-pathway procedures, CTI ablations for typical atrial flutter, atrial tachycardia procedures, AV-node ablations, atrial-fibrillation ablations, ventricular tachycardia/PVC ablations, and diagnostic EP studies.
Candidates must also provide supporting documentation, including a letter of endorsement from a national cardiac society or working group and a supervisor support letter.
How Can You Prepare for the EHRA EP Exam?
A strong preparation strategy should combine clinical knowledge, guideline-based learning, and scenario-based question practice.
Study the EHRA Core Curriculum
Because EHRA states that questions cover the entire electrophysiology curriculum, candidates should use the Core Curriculum as a framework for identifying knowledge gaps.
Review Clinical Cases
The exam uses clinical scenarios, so preparation should involve interpreting patient presentations, ECG and electrophysiological findings, procedural information, and treatment considerations.
Build Procedural Understanding
Candidates should understand the principles behind diagnostic EP studies, mapping, catheter manipulation, and ablation rather than relying solely on memorized facts.
Read Widely
EHRA explicitly recommends broad reading because there is no single source from which all examination questions are developed. It also provides a suggested reading list and sample questions for candidates.
Use Practice Questions Responsibly
Practice questions can help candidates become familiar with clinical scenario-based testing and identify weak areas. They should be used as a learning tool alongside official EHRA materials rather than as a substitute for genuine preparation.
Why Is the EHRA EP Certification Relevant?
Invasive cardiac electrophysiology requires knowledge spanning cardiac rhythm disorders, diagnostic procedures, electrophysiological mechanisms, mapping, ablation, and clinical decision-making.
The EHRA certification programme provides a structured assessment of theoretical knowledge and, for physicians, documented practical experience. EHRA states that full certification is granted after completion of both the examination and logbook components.
The certification is valid for 10 years, after which candidates must follow the applicable recertification process to maintain it.
FAQs About the EHRA EP Exam
What does EP mean in EHRA certification?
EP stands for Invasive Cardiac Electrophysiology, the area of cardiac medicine concerned with diagnosing and treating heart-rhythm disorders using electrophysiological techniques.
How many questions are on the EHRA EP exam?
The physician EP examination contains 130 multiple-choice questions, divided into two groups of 65 questions.
Is the EHRA EP exam online?
Yes. EHRA usually conducts the examination through an online proctoring system, allowing candidates to take it remotely on their own computer under human supervision.
Is the exam negatively marked?
No. EHRA states that there is no negative marking.
Is the logbook required for physicians?
Yes. Physicians seeking the full EHRA EP certification must complete the written examination and subsequently meet the logbook requirements demonstrating practical electrophysiology experience.
How many EP procedures are required for the logbook?
The current physician requirements call for evidence of 200 EP procedures, with specific minimum numbers across several procedure categories.
Final Thoughts
The EHRA Online Invasive Cardiac Electrophysiology (EP) examination assesses broad electrophysiology knowledge through clinical scenario-based multiple-choice questions. For physicians, it forms the first part of a larger certification programme that also requires documented practical experience through a logbook.
Candidates should base preparation on the current EHRA Core Curriculum, official examination blueprint, suggested reading list, and sample questions. Current EHRA requirements should always take priority over unofficial exam material, particularly because examination schedules, requirements, and certification procedures can be updated.
