Certified Cardiographic Technician (CCT)

Requires: Passing the one-part Certified Cardiographic Technician Examination

Who should apply: Professionals who work in the areas of ECG, Holter monitoring, and stress testing

Specialty Examination Fee: $175


Click here for information on ordering the Self Assessment Examination


CCT Navigation

All applicants must meet the following criteria:

1. Have a high school diploma or general education diploma at the time of application.

2. Fulfill one (1) of the qualifications of the exam for which you are applying. See qualifications listed in the tables below.

3. Provide typed documentation to support the qualification under which you are applying. Required documentation for each qualification is listed below. CCI reserves the right to request additional information.


Qualification Prerequisite # Qualification Prerequisite Supporting Documentation
CCT1 Currently enrolled as a student or a graduate of a cardiovascular or allied health training program.

Completion certificate


Student Verification Letter


Educational Transcripts

CCT2 Currently employed or previously employed in the field of Cardiovascular Technology or in a recognized allied health field (recognized by the American Medical Association [AMA]). Employment Verification Letter 
CCT3 Completed requirements for a graduate undergraduate degree from a recognized institution in a field related to science or OR physical health.

Completion certificate


Student Verification Letter


Educational Transcripts

CCT4 Volunteer service in the field of Cardiovascular Technology for a minimum of two (2) years and documentation supporting full-time technical activities for a two (2) year period. Employment Verification Letter 

Click here for sample Student Verification Letter and Employment/Volunteer Verification Letter.

CCI requires the Student Verification Letter contain the following:

1) Educational program’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by educational director.
3) Indicate the name of the applicant.
4) Indicate full- or part-time student.
5) Indicate the date or expected date of graduation.
6) Indicate the specialty of the educational program.
7) Original signature of direct supervisor or employer.

CCI requires the Employment/Volunteer Verification Letter contain the following:

1) Employer’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by employer/supervisor.
3) Indicate the name of the applicant.
4) Indicate full- or part-time employment.
5) Indicate the time period of employment.
6) Indicate the primary duties of applicant, related to the field of cardiovascular technology.
7) Original signature of direct supervisor.

CCT Matrix & Task List Sunday, November 08th 2009 10:00 PM

Examination Matrix

The examination matrix is provided to illustrate the general distribution of questions and the relative weight or emphasis given to a skill or content area on the examination.


A. Conducting Pre-Procedural Activities 10%
B. Performing Resting ECG (12-Lead, 15-Lead, etc.) 40%
C. Performing Stress Tests 20%
D. Performing Ambulatory Monitoring (Holter, Event, Telemetry, Transtelephonic, Pacemaker, etc.) 5%
E. Performing Rhythm Analysis 25%
TOTAL 100%

Knowledge List

The list below describe general areas of knowledge that are needed in order to perform the tasks identified. This knowledge will apply across multiple tasks.

Size Venules

Bipolar, unipolar and precordial leads Einthoven's triangle and law

Location  Cardiac valve function ECG calibration methods
Layers Pressures Single and three channel ECG

Relationship of cardiac output to heart rate and stroke volume

Troubleshooting ECGs
Valves Control mechanisms Standardization
Blood flow Cardiac cycle Paper speed
Arteries Normal values Lead placement
Veins Waveforms Electrical interference
Capillaries ECG measurement Somatic tremor



Task List

The task list below describes the activities that a Cardiographic Technician is expected perform on the job. All examination questions are linked to these tasks.

Duties and Tasks % of Exam
A Conducting Pre-Procedural Activities 10%
1 Receive doctor’s orders  
2 Verify doctor’s orders  
3 Perform universal precautions (e.g., handwashing, PPE)  
4 Identify patient  
5 Obtain patient consent  
6 Transport patient  
7 Prepare the patient (shaving, cleaning skin, etc.)  
8 Identify proper landmarks  
9 Collect patient demographics  
10 Enter patient information into ECG machine  
11 Identify patient safety hazards  
B Performing Resting ECG (12-Lead, 15-Lead, etc.) 40%
1 Gather supplies and equipment  
2 Educate patient on procedure expectations  
3 Apply electrodes to patient  
4 Confirm equipment  
5 Perform standard ECG  
6 Perform right side  
7 Analyze ECG tracing  
8 Corrolate ECG morphology with anatomy and physiology  
Duties and Tasks % of Exam
C Performing Stress Tests 20%
1 Gather supplies and equipment  
2 Explain patient safety procedures and protocol expectations  
3 Perform baseline ECG and obtain vital signs  
4 Verify stress test protocol  
5 Perform stress test protocol  
D Performing Ambulatory Monitoring (Holter, Event, Telemetry, Transtelephonic, Pacemaker, etc.) 5%
1 Gather ambulatory monitoring supplies and equipment  
2 Explain procedure to patient  
3 Verify equipment functionality  
4 Attach leads to patient (stress loops, pouch, etc.)  
5 Explain ambulatory monitoring requirements (limitations, expectations, duration etc.)  
E Performing Rhythm Analysis 25%
1 Analyze obtained data  
2 Correlate ECG findings (waveforms, segments, intervals, etc.) with cardiac function  
3 Identify, report, and record findings  
Total   100%
  1. The heart is divided into ______ chambers:
    1. One
    2. Two
    3. Four
    4. Three
  2. Which of the following supplies blood to the arterial system after contraction?
    1. Left atrium
    2. Right atrium
    3. Left ventricle
    4. Right ventricle
  3. The Sensitivity switch controls the:
    1. Heat
    2. Speed
    3. Amplification
    4. ECG position
  4. The little "spark" that makes the heart beat, originates in the:
    1. AV node
    2. SA node
    3. Purkinje fibers
    4. Bundle branches
  5. Which of the following is a poor conductor of electric current?
    1. Metal
    2. Blood
    3. Dry skin
    4. Body fluids

1. c  2. c  3. c  4. b  5. c

The textbooks listed below are intended as recommended resources when preparing for examination. You may have previous or later editions of these or other references available that also present acceptable coverage of the subject matter. Any general text in cardiovascular techniques and evaluation, and cardiac patient care and management may be used. It is not necessary to use all of the texts identified. They are provided as suggestions only. CCI does not endorse or recommend any third-party review course or material.


    1. Shier, David, Jackie Butler, and Ricki Lewis. Hole’s essentials of human anatomy and physiology. 9th ed. Boston: McGraw-Hill, 2006.
    2. Booth, Kathryn A., and Thomas E. O’Brien. Electrocardiography for healthcare professionals. 3rd ed. New York: McGraw-Hill, 2012.
    3. Dubin, Dale. Rapid interpretation of EKG’s: an interactive course. 6th ed. Tampa, Fla.: Cover Pub. Co., 2000.
    4. Green, Jacqueline M., and Anthony J. Chiaramida. 12-Lead EKG Confidence a Step-by-Step Guide. 2nd ed. New York: Springer Pub. Co., 2009.
    5. Phalen, Tim, and Barbara Aehlert. The 12-lead ECG in acute coronary syndromes. 2nd ed. St. Louis: Elsevier Mosby, 2006.
    6. Wagner, Galen S., and Henry J. L. Marriott. Marriott’s practical electrocardiography. 11th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008.
    7. Wesley, Keith. Huszar’s basic dysrhythmias and acute coronary syndromes: interpretation and management. 4th ed. Elsevier- Health Sciences, 2011.



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