Exam Overview

Registered Cardiovascular Invasive Specialist (RCIS)

Examination Matrix

This 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.

Content Category Approximate Percentage of Examination
Conducting Pre-Procedural Activities 10%
Conducting Intra-Procedural Activities 40%
Conducting Invasive Procedures 40%
Conducting Post-Procedural Activities 10%
Total 100%

Knowledge List

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

• Calculation/conversion skills
• Units of measurement
• Shunt calculations, VOA
Medical terminology
Cardiovascular anatomy and physiology
Cardiovascular pathology and pathophysiology
Body mechanics
Regulatory and compliance standards
Patient care and assessment
Normal and abnormal lab values
ECG interpretation and analysis
Pharmacology and medication administration
Hemodynamic waveform recognition
• Angiography
• Radiation safety
• Operation of radiographic equipment
Sterile technique
Universal precautions
Diagnostic and interventional procedures
• Cardiac procedures
• Vascular procedures
• Device implants
• Procedural indications, contraindications, and complications
Emergency procedures and equipment

Task List

The task list below describes the activities which a Registered Cardiovascular Invasive Specialist is expected to perform on the job. All examination questions are linked to these tasks.

Duties and Tasks % of Exam
A Conducting Pre-Procedural Activities 10%
 1 Prepare procedure room (e.g., set up equipment, QC, QA)  
 2 Review patient chart (e.g., lab results, consent, verifying orders, medical record)   
3 Prepare patient for procedure (e.g., patient ID/verification, start IV, educate patient)  
 4 Set up sterile field (e.g., patient, procedure table, equipment)  
B Conducting Intra-Procedural Activities 40%
 1 Monitor vital signs of patients (e.g., heart rate rhythm, blood pressure, respiratory rate, O2 saturation)

5 Monitor ACT (Activated Clotting Time)
6 Ensure radiation safety (e.g., time, distance, shielding)
7 Position radiographic equipment (e.g., C arm, pan table, angles & views)
8 Acquire/interpret radiographic images (administer contrast)
9 Administer conscious sedation (e.g., levels, Aldrete, assessing effects)
10 Place arterial lines
11 Place venous lines
12 Perform intra-coronary injection
13 Perform cardiac outputs (e.g., TDCO)
14 Perform endomyocardial biopsy
15 Respond to intra-procedural emergency situations (e.g., anaphylaxis, cardiac arrest, cardiogenic shock, tamponade, ACLS)

 2  Evaluate hemodynamic data (e.g., pressure waveforms, CO, Fick, Shunt, PVR, SVR, valve areas)  
 3  Perform 12-lead ECG analysis (e.g., infarct, bundle branch, ischemia, tamponade)  
 4  Understand pharmacologic effects of medications (e.g., ACLS, recognize side effects/adverse reactions, pain management)  
C Performing Invasive Procedures 40%
 1 1 Perform adult cardiac catheterization
2 Perform Intra-vascular ultrasound (IVUS)
3 Perform Intra-cardiac echocardiography (ICE)
4 Perform Fractional Flow Reserve (FFR)
5 Perform device implants (e.g., pacemaker, ICD)
6 Perform coronary balloon angioplasty (including CTO devices)
7 Perform peripheral interventions (e.g., carotids, renals, SFAs, vena cava filters)
8 Perform coronary stenting
9 Perform rotational atherectomy
10 Perform laser interventional procedures
11 Perform IABP insertion (intra-aortic balloon pump)
12 Insert and operate transvenous temporary pacemaker
13 Perform pericardiocentesis
14 Perform transcatheter valve repair/replacement
15 Perform structural heart disease interventions (e.g., ASD/PFO, VSD, PDA)
16 Perform percutaneous valvuloplasty
17 Operate thrombectomy equipment (e.g., Angiojet, aspiration catheter)
18 Implant percutaneous left ventricular assist device (e.g., LVAD, Impella)
19 Assist with transseptal puncture
20 Insert distal protection devices
Duties and Tasks % of Exam
D Conducting Post-Procedural Activities 10%
  1 Obtain femoral hemostasis with manual pressure
2 Obtain femoral hemostasis with collagen closure device
3 Obtain femoral hemostasis with mechanical device
4 Obtain radial hemostasis manually or with mechanical device
5 Manage access site complications
6 Respond to post-procedure emergency situations (e.g., vasovagal, anaphylaxis, retroperitoneal bleed)
Total   100%
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