EP Exam Review - Volumes 1 and 2: RCES and CEPS Basics

In this book review, Christine Chiu-Man, MSc, FHRS, RCES, CEPS, CCDS, describes the new second-edition set of EP Exam Review - Volume 1 Basics: RCES and CEPS Basics, and EP Exam Review - Volume 2: Diagnosis & Therapy for RCES and CEPS by Wes Todd, RCIS, RCES, RCSA, and April Edberg, RCIS, RCES, CEPS, CCDS.

This two-volume companion of EP exam reviews is a must for those who are new to the field of EP or for those planning to take the registry exam from CCI (RCES), and it is a helpful adjunct to those who plan to take the IBHRE board exam (CEPS). The purpose of this book is to supplement the reader’s education, self study, or clinical experience to improve the chance of successfully passing the exam. For those new to the field, this book serves to identify areas of expected competencies that the reader can focus on to strengthen their knowledge.

There are 12 chapters in this companion, covering categories in the content outlines of both exams. These categories include basic EP, anatomy, physiology, pathology, arrhythmia, technical aspects such as EP equipment, vascular access, ECG and EGM interpretation, mapping, radiology, EGM diagnosis of arrhythmia, medications, and basic device therapy. What is particularly striking about this book is its practicality. The questions are what the EP specialists encounter in their day-to-day work within the lab: calculating the infusion rate, performing arterial puncture, starting an IV, landmarking for ECG lead placement, recognizing fluoroscopic catheter positions, recognizing incomplete CTI block post flutter ablation, differentiation of SVT, performing entrainment pacing, reading 3D activation maps, determining pacemaker threshold, troubleshooting device diagnostics, and many more. Many of the diagrams drawn by Wes Todd are lighthearted and witty, and make it all the more interesting. The only drawback is that the 3D maps are not printed in color, but rather, are color labeled, and a few of the intracardiac recordings are not as sharp as they could be. 

With over 1,400 questions and answers, the reader is engaged in active thinking while going through these questions, making it hard to put this book aside. Each correct answer is substantiated by a reference that the reader can study in greater depth. The format of the questions varies and resembles those found in the CCI exam rather than the IBHRE exam. While there are similarities in both exams in terms of the assessment of core EP knowledge, the CCI exam included testing aspects of intraprocedural tasks such as vascular access and scrub assist, which may be part of the role of the CVT in many parts of United States, but less so in other world regions. However, it is also my belief that just because you don’t do the tasks, doesn’t mean you shouldn’t learn or know anything about it. The lab environment is collaborative, and the more we know, the more we can help each other with troubleshooting when problems arise. This book gives us the opportunity to learn more about these diverse tasks — information that is not often found in regular EP textbooks. On the other hand, the IBHRE exam is a board certification exam developed in conjunction with the National Board of Medical Examiners, which focuses more specifically on core and advanced EP knowledge. This review book has a definite advantage to help reinforce the basic foundation necessary in preparing for this exam, but the reader will need to go further to study from other textbooks and references. 

Wes Todd has been a self-taught CVT since 1970, and has been in the business of teaching and certification for CVTs for many years. His passion for continuous education led him to develop review books for the RCIS, even into his retirement from the lab. More recently, he partnered with April Edberg, a 15-year veteran from the cath lab who has been certified in RCES and CEPS to develop the EP exam review books, and this is now their second edition. Wes and April have a keen sense of what knowledge and competence a novice entering the field should know. With such a comprehensive set of review questions, this book is a definite bang for the buck! Achieving competence in the field depends on using a variety of resources, and this volume set is an unequivocal complement to the educational tools in the EP field.