Certified Rhythm Analysis Technician (CRAT)

The Certified Rhythm Analysis Technician (CRAT) examination is for professionals who utilize specialized monitoring equipment to analyze cardiac rhythms.

This computer-based exam is administered at Pearson Professional Centers year-round based on availability at the test centers. To locate a test center click here.

Try Our Qualification Pathway Tool

By answering the questions below this tool will help determine which exam pathway you are best qualified to take.

Are you currently enrolled as a student or are you a graduate of a cardiovascular or allied health training program?


The fee for the CRAT examination is $175 USD. All exam fees include a $100 non-refundable fee for the staff resources required to review and process applications.


The Certified Rhythm Analysis Technician (CRAT) exam is a two-hour, computer-based exam that contains 130 questions.

Certified Rhythm Analysis Technician (CRAT) Qualification Requirements

Applicants are required to 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 the 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 Pathway Tool

To determine your eligibility, use the questionnaire tool below. The qualification pathway tool will help you determine if you are eligible. It does not guarantee eligibility but serves as a guide in helping you apply for the exam.

Are you currently enrolled as a student or are you a graduate of a cardiovascular or allied health training program?

Download Resources

Choose one of the qualification pathways below

CRAT1 Qualification Pathway

Currently enrolled as a student or a graduate of a cardiovascular or allied health training program.

CRAT1 Supporting Documents

Completion certificate
Student Verification Letter
Educational Transcripts

CRAT2 Qualification Pathway

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).

CRAT2 Supporting Documents

Employment Verification Letter

CRAT3 Qualification Pathway

Completed requirements for a graduate or undergraduate degree from a recognized institution in a field related to science or physical health.

CRAT3 Supporting Documents

Completion certificate
Student Verification Letter
Educational Transcripts

Apply for the Certified Rhythm Analysis Technician (CRAT) Exam

Applying for the exam will take place through your CCI online account.

To prepare, create an online profile by clicking either “CREATE AN ACCOUNT” at the top of this website or if you already have an existing profile, click “SIGN IN.”

Before starting the online submission review each of the tabs in this section and collect the following information which may be needed to complete the application.

  • Personal contact information
  • Training program(s) contact information
  • Supporting documents from your training program(s) in PDF format
  • Employer contact information
  • Supporting documentation from your employer(s) in PDF format
  • Payment information

Once submitted, processing a complete application requires a minimum of 15-20 business days.

Helpful Resources

Pre-Application Policy Pertaining to Criminal Matters

If you have been convicted, pled guilty, or pleaded no contest for an offense that is classified as a misdemeanor or felony, or if you have questions regarding personal criminal matters you may request a pre-application of criminal matters to determine whether you qualify for the CCI credentialing process.

Pre-Application requests must be made by the applicant. Pre-Application requests will not be accepted from any third party, including but not limited to educational programs.

A $50.00 USD fee is required at the time of Pre-Application and this fee is non-refundable.

CCI reserves the right to deny an application, revoke the eligibility of a candidate, or take action against any registrant who has been convicted, pled guilty, or pled nolo contendere (no contest) to an offense that is classified as a misdemeanor or felony which is directly or indirectly related to patient care or public health. Crimes that may directly or indirectly relate to patient care or public health include, but are not limited to: murder; attempted murder; manslaughter; rape; attempted rape; sexual assault; sexual abuse; assault; driving while intoxicated or impaired; controlled substance abuse; and fraudulently altering medical documentation, insurance claims, and medical prescriptions.

Requests for Special Accommodations

CCI will provide, upon approved request, reasonable accommodations including auxiliary aids and services necessary to afford an individual with a documented disability an equal opportunity to participate in all services, programs, and activities. To request special accommodations, please provide an original letter signed by the applicant and an evaluator (qualified psychologist, physician, or other health care professional) who specializes in the stated disability. This letter should include the following:

  1. The specific diagnosed disability
  2. The specific functional limitations
  3. Impact of the functional limitations on the individual’s ability to participate in the testing activity
  4. What accommodations or assistive devices, if any, would cancel or ease the impact of the disability on the candidate’s ability to participate in the examination process

Additional documentation required for accommodations requests:

  1. Verification of the evaluator, psychologist, physician, or health care professional credentials and specialty in the diagnosis of the stated disability.
  2. Examples, when possible, of where special accommodations have been requested and granted. If no prior accommodations have been provided, the evaluator, psychologist, physician, or health care professional should include a detailed explanation as to why no accommodations were given in the past and why accommodations are needed now.


Certified Rhythm Analysis Technician (CRAT) Exam Preparation

The CRAT examination is designed to assess knowledge and skills in current practice. CCI provides an overview of the examination content including knowledge and task list. Preparation for CCI examinations can be overwhelming, and several options can assist you in your preparation.

The examination content is based on the findings of a Job Task Analysis (JTA), which describes the overall tasks that a CRAT is expected to perform on the job and general areas of knowledge that are needed to perform the tasks. A JTA is performed every 5 years for all nine of the examinations that CCI offers in order to keep exams relevant to current practices in the field.  Examination content was developed by subject matter experts in the cardiovascular profession and ongoing statistical analyses were provided by testing professionals with a doctorate in Industrial and Organizational Psychology.

The lists below describe general areas of knowledge that are needed in order to perform the tasks identified. The task listing illustrates the relative weight or emphasis given to the main content areas on the examination.

Knowledge List

  • Regulatory and compliance standards (e.g., OSHA, HIPAA, informed consent, medical records)
  • Medical ethics
  • Communication with the client
  • Communication with staff and faculty
  • Patient safety
  • Emergency response
  • Basic cardiovascular anatomy and physiology
  • Cardiac rhythm analysis and interpretation
  • ECG troubleshooting
  • Documentation of findings
  • Medical terminology

Exam Matrix and Task List (as of July 1, 2023)

To help assure quality and relevance, CCI conducts reviews of our exam programs to ensure they remain relevant for our industry professionals.       

The following examination matrix is the result of a recent job task analysis review. 

Duties and Tasks

% of Exam

Duties and Tasks

A. Initiating Cardiac Monitoring Services

% of Exam


Duties and Tasks

  1. Verify patient identification
  2. Review patient diagnosis, history, and/or reason for monitoring
  3. Provide education to patients and/or care team (e.g., cardiac monitoring service, device information, placement, safety, care)

Duties and Tasks

B. Administering Cardiac Tests

% of Exam


Duties and Tasks

  1. Place cardiac monitoring device
  2. Evaluate quality of ECG (e.g., minimizing interference, troubleshooting)
  3. Correlate patient symptoms to events and/or rhythms
  4. Recognize standard ECG settings

Duties and Tasks

C. Analyzing Normal Rhythms

% of Exam


Duties and Tasks

  1. Identify normal ECG components
  2. Identify cardiac anatomy and physiology
  3. Correlate ECG morphology with cardiac anatomy and physiology
  4. Identify sinus rhythms, rates, regularity, and wave morphology

Duties and Tasks

D. Analyzing Abnormal Rhythms

% of Exam


Duties and Tasks

  1. Identify atrial fibrillation
  2. Identify atrial flutter
  3. Identify atrial arrhythmias
  4. Identify junctional arrhythmias
  5. Identify ventricular arrhythmias
  6. Identify asystoles
  7. Identify ventricular tachycardia
  8. Identify ventricular fibrillation
  9. Identify paced rhythms
  10. Identify intraventricular conduction delays
  11. Identify AV conduction defects
  12. Recognize artifacts

Duties and Tasks

E. Processing Cardiac Test Findings

% of Exam


Duties and Tasks

  1. Prioritize ECG results
  2. Compile test findings
  3. Conduct follow-up activities

Self-Assessment Exams

There are several options that can assist your preparation, including CCI’s Self-Assessment Examinations which can be found here.

We have prepared online self-assessment exams to help gauge your knowledge of the content areas on the exam and help determine which areas may have strengths and weaknesses. The self-assessment exam contains sample items covering the approximate proportion of subject matter to match the CCI exam matrix.

Self-assessment exams do not provide a report of missed items or specific information or feedback on incorrect responses. Once the self-assessment is complete, you will receive a performance profile that displays the percentage of correct responses in the content areas that make up the examination.

It is important to note that the results of the self-assessment exam do not guarantee or indicate individual success on the exam, nor should the self-assessment serve as the only means for preparing for the examination.

Examination Details

Exam Time

The CCT examination is a two-hour (2-hour) computer-based test.

Question Types

Question types consist of 130 questions (110 scored and 20 unscored), that contain a mix of traditional and innovative item types.

  1. Traditional multiple-choice – Only one of four possible answers is correct (e.g. A, B, C or D).
  2. Innovative multiple responses – Two or three answers are correct from a list of four to six possible answers.  The test taker will be instructed to select a certain number of correct answers (e.g. “Select two correct responses.”)
  3. Innovative hot spot – The test taker will be instructed to click on one specific area of an image to answer the question.  Only one answer (click) is necessary, but it must be in the correct location.
  4. Innovative drag and place – The test taker will be instructed to drag a collection of labels (tokens) into specific boxes or areas on an image.  The correct tokens will need to be placed in the correct boxes in order to get the question right. It’s possible that all tokens may not be used.


The 20 unscored questions are not identified and are randomly distributed throughout the exam to gather performance data. A candidate’s exam score is based on the responses to the 110-scored questions. One hour and fifty (50) minutes are allotted for answering the exam questions and ten (10) minutes for a pre-exam tutorial and post-exam survey.


The textbooks listed below are intended as recommended resources when preparing for the 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 on 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. Asirvatham, Samuel J., Friedman, Paul A., and Hayes, David L. Cardiac pacing, defibrillation and resynchronization: a clinical approach. Chichester, West Sussex, UK: Wiley-Blackwell.
  2. Barold, S. Serge, and Roland X. Stroobandt. Cardiac Pacemakers and Resynchronization Step by Step an Illustrated Guide. 2nd ed. Chichester: John Wiley & Sons, 2010.
  3. Booth, Kathryn A., and Thomas E. O’Brien. Electrocardiography for healthcare professionals. New York: McGraw-Hill.
  4. Dubin, Dale. Rapid interpretation of EKG’s: an interactive course. 6th ed. Tampa, Fla.: Cover Pub. Co., 2000.
  5. Kenny, Tom. The nuts and bolts of cardiac pacing. 2nd ed. Malden, Mass.: Blackwell Futura, 2008.
  6. Wesley, Keith. Pocket Guide to Huszer’s Basic Dysrhythmias and Acute Coronary Syndromes: Interpretation & Management. Mosby Jems Elsevier.
  7. Woods, Stephanie L. and Karen S. Ehrat. The Art of EKG Interpretation:  a Self-Instructional Text. Dubuque, Iowa: Kendall Hunt Pub Co.

Once Approved to Take the CRAT Exam Your 90-day Window Begins!

You will be sent, via email, an Authorization to Test (ATT) within 2 business days after your application has been approved. Consider your 90-day eligibility window to take the examination, now open. The ATT provides instructions and details for scheduling your test date and location.


  • Once you have received an Authorization to Test (ATT) from CCI, then you may contact Pearson VUE to schedule your exam. Available sites may be viewed at www.pearsonvue.com/cci.
  • CCI’s credentialing examinations are administered year-round at over 230 Pearson Professional Centers (PPC) in the United States and US territories and over 3,000 Pearson VUE Authorized Test Centers (PVTC) internationally. Examination site availability is provided when scheduling your examination with Pearson VUE.

Learn more about our exam process steps here!

If you need to reschedule your examination:

  • Contact Pearson VUE at least two full working days in advance of your scheduled appointment. Call (800) 869-4102, 7:00 am to 7:00 pm, Central Standard Time, Monday – Friday. Outside the U.S.: (952) 681-3789) or www.pearsonvue.com/cci
  • If you do not contact Pearson VUE two working days in advance of your scheduled appointment you cannot reschedule the examination.
  • Click here to review CCI’s exam cancellation/refund policy.

To request an extension or refund:

  • Candidates may request one extension to their originally issued Authorization to Test (ATT). The extension will be for a period of 90 days.
  • To request an extension or refund, sign into your CCI account.
  • Select Cancel Exam.
  • Select which exam to cancel.
  • Select the type of cancellation (extension or refund), enter the cancellation reason, and submit the cancellation for review.

If the exam is not taken by the end of the extension period, the testing fee will be forfeited, and the applicant will need to reapply to take the test. If the applicant has made an appointment with Pearson prior to requesting the extension, the appointment must be canceled before CCI is contacted for an extension or refund.

If you experience the death of an immediate family member, suffer a serious illness or injury which requires hospitalization, or experience another event causing emotional distress, and such events conflict with the administration of your examination, then you may be permitted to reschedule your examination authorization window without penalty, upon approval from CCI. All such instances must be documented in writing and sent to CCI headquarters within three (3) days of the initially scheduled examination date.

Exam Day is Here!

A few tips for our test-takers:

  • Be well-rested, hydrated and be sure to eat a meal or snack
  • Give yourself enough time to get to the test center, and park
  • Bring the proper IDs with you, details below
  • Read all test instructions and candidate rules thoroughly
  • Take your time and read exam questions carefully

Important to note, the only people admitted into the examination room are:

  1. Test Administrators
  2. Authorized Candidates

Identification (ID) Requirements

  • The first and last name that the candidate uses to register must match exactly the first and last name on both of the IDs that are presented on test day.
  • All IDs required must be issued by the country in which the candidate is testing. If the candidate does not have a qualifying primary ID issued from the country they are testing in, an International Travel Passport from their country of citizenship is required, along with a secondary ID.
  • Candidates are required to present two forms of original (no photocopies), valid (unexpired) IDs; one form as a primary ID (government issued with name, recent recognizable photo, and signature) and one form as a secondary ID (with at least a name and signature, or name and recent recognizable photo).

Primary ID:

  • International Travel Passport
  • Driver’s license
  • Military ID (including spouse & dependents)
  • Identification card (national/state/province identity card)
  • Alien registration card (green card, permanent resident, visa)
  • Local language ID (not in Roman characters) – accepted only if issued from the Country the Candidate is testing in

Secondary ID:

  • Any ID containing at least name and signature, or name and recent recognizable photo that meets the above ID requirements

Click here to view Pearson VUE ID Policy

Exam Questions, Comments, and Scoring

The CRAT examination is a two-hour, computer-based exam that contains 130 questions (110 scored and 20 unscored). One hour and fifty (50) minutes are allotted for answering the exam questions and ten (10) minutes are allotted for a tutorial and post-exam survey.

A candidate’s exam score is based on the responses to the 110-scored questions. The time you have been allotted to take the examination has been determined by taking into consideration the number of scored and un-scored items.

Each question is shown with four possible answers, only one of which is the correct or best answer. Unscored questions are not identified and are randomly distributed throughout the exam. This is standard practice and enables CCI to evaluate questions that may be used in future examinations.

Each CCI examination, including individual items, contains an option where a candidate is allowed to make comments pertaining to the exam item and/or the examination as a whole. These comments are reviewed by the appropriate examination committee throughout the year. While responses to comments are not provided back to you, your comments will be used to help ensure the maintenance of CCI’s high-quality examinations.

Interpreting Results

Here’s what you can expect after taking the exam

  • Exam takers will receive an unofficial score report onsite at the Pearson VUE testing center. This will provide a total score, pass/fail status, and a breakdown report of the percentage of questions answered correctly in each content area.
  • Total scores are reported on a scale that ranges from 0 to 900. Keep in mind that CCI total scaled scores do not equal the number or percentage of questions answered correctly.
  • A total scaled score of 650 is required to pass an exam, and the number of correct answers required to achieve a score of 650 was determined through a standard-setting (or passing score) study. CCI and panels of experts from each specialty periodically review the passing score to assure its validity.
  • You will receive an official results letter, certificate, and wallet card from CCI headquarters approximately 15 business days after taking an exam.

Score Verification

If you would like a score verification, there is a processing fee of $50 USD.

Score verification ensures that the computer counted the correct and incorrect answers appropriately but does not review the questions and answers. In deciding whether to have your score verified, please consider that CCI examinations are scored electronically with a high degree of accuracy. It is therefore unlikely that verification will alter your original score.

  • You must submit a written request for score verification.
  • Please print or type all information and include a check, money order, or credit card processing fee in the amount of $50 USD.
  • Send your request to: CCI at 3739 National Drive, Suite 202, Raleigh, NC 27612

Maintaining Credentials

A credential is active for 9-12 months after passing a CCI exam. After that period credential holders have two types of renewal with CCI:

  • First renewal
  • Second renewal/first triennial

First Renewal Requirements

New credential holders are required to pay their first renewal before the first day of the same quarter that the credential was earned but in the following year. SEE THE CHART BELOW.

For example, if the credential is earned between April 1st and June 30th, your first renewal would be due on or before March 31st of the following year.

After completing the first renewal, credentials are renewed every three years.

For the first renewal, there are no Continuing Education Unit (CEU) requirements, only a renewal fee, currently $165.00 USD, and a signature of compliance with the Code of Ethics must be submitted. Your date of renewal will be noted on your initial wallet card, which will be sent in your welcome packet.

Second Renewal/First Triennial Requirements

Maintaining an “active status” as a CCI credential holder requires the following three steps. Until all three are fulfilled, your credential will not be renewed.

  1. Submit your triennial renewal fees (currently $165.00 USD)
  2. Sign in compliance with the CCI Code of Ethics, which can be downloaded through the button above.
  3. Complete Continuing Education Units (CEUs)* every three years.
    • The total number of CEUs required in a triennial cycle for a Certificate-Level (CCT and CRAT) is sixteen (16) CEUs.
    • The total number of CEUs required in a triennial cycle for an Advanced-Level (ACS) is thirty-six (36) CEUs.
    • The total number of CEUs required in a triennial cycle for a Registry-Level (CES, RCIS, RCS, RCCS, RPhS, and RVS) is thirty-six (36) CEUs.

For the advanced and registry levels, thirty (30) of these CEUs must be cardiovascular-related. The remaining 6 or fewer CEUs can be on any topic as long as it is from one of the approved providers

Wallet cards are provided to successful exam candidates and expire on the date of the first renewal. Triennial wallet cards are provided upon the second renewal of credentials.

When Credential is Earned*

First Renewal End Date**

Second Renewal Cycle (when CEUs are due)

When Credential is Earned*

January 1 to March 31, current year

First Renewal End Date**

December 31, current year

Second Renewal Cycle (when CEUs are due)

December 31, three years after first renewal

When Credential is Earned*

April 1 to June 30, current year

First Renewal End Date**

March 31, following year

Second Renewal Cycle (when CEUs are due)

March 31, three years after first renewal

When Credential is Earned*

July 1 to September 30, current year

First Renewal End Date**

June 30, following year

Second Renewal Cycle (when CEUs are due)

June 30, three years after first renewal

When Credential is Earned*

October 1 to December 31, current year

First Renewal End Date**

September 30, following year

Second Renewal Cycle (when CEUs are due)

September 30, three years after first renewal