Format at a glance
| Item | Detail |
|---|---|
| Questions | 200 multiple choice |
| Time | 240 minutes in 4 sections, 6-minute breaks; no going back to a finished section |
| Delivery | PSI test centers in North America and internationally |
| Next exam | August 4, 2027 (applications close March 18, 2027) |
| Fee | US$1,090, all categories including retakes |
| Pass mark | Not published; criterion-referenced cut score, reported as a scaled score |
| Pass rate | 66.57% in 2025 (IBHRE) |
The 10 domains (2026 outline)
- Patient and Device Follow-Up Management (20%): interrogation, programming, troubleshooting, diagnostics, remote monitoring.
- Fundamental Knowledge of Device Functions and Algorithms (14%): bradycardia and tachycardia features, CRT and conduction system pacing.
- Clinical Assessment and Device Indications (11%): history, indications, pharmacology.
- Perioperative and Intraoperative Practice (11%): implant technique, testing, complications, infection prevention, parameter selection.
- Fundamental Knowledge of Device Technology and Design (10%): sensing, stimulation, timing cycles.
- Fundamental Knowledge of Engineering and Electrical Concepts (9%): electronics, pulse generators, leads, defibrillation.
- Electrocardiography (8%): paced rhythms, malfunction and pseudo-malfunction, wearable monitor data.
- Safety (7%): EMI, MRI, radiation therapy, device-device interaction, cremation, advisories.
- Radiology (6%): X-ray, fluoroscopy, CT and echo.
- Fundamental Knowledge of Electrophysiology (4%): anatomy, mechanisms of arrhythmia.
What gets tested most
Tracings and timing. Expect paced ECGs and intracardiac EGMs where you have to identify oversensing, undersensing, loss of capture, upper-rate behavior or a programmed feature that looks like a fault. Short calculations come up too: Ohm's law, VA interval, total atrial refractory period and the 2:1 block rate.
See where you stand in 10 minutes
Take the free CCDS practice test. 15 questions, every answer explained.
Pacing
200 questions in 240 minutes is 72 seconds each. Each section has a hard time limit and unused time doesn't carry over, so pace each section separately. Use the on-screen calipers on tracing questions.
A 12-week plan
- Weeks 1-2: engineering and electrophysiology fundamentals; Ohm's law and timing cycles until they're automatic.
- Weeks 3-5: device functions and algorithms, then ECG and paced rhythms.
- Weeks 6-8: indications, implant practice, safety and radiology.
- Weeks 9-10: follow-up and troubleshooting, the largest domain; first full timed mock.
- Weeks 11-12: clear your mistakes bank, second full mock, light review in the last two days.
Frequently asked questions
How many questions are on the CCDS exam?
200 multiple-choice questions in 240 minutes, split into 4 timed sections.
How much does the CCDS exam cost?
US$1,090 for the August 4, 2027 exam. The fee is the same for HRS members, non-members and retakes.
What is the CCDS pass rate?
IBHRE reported 66.57% for the 2025 allied CCDS exam, and an average of about 68% across all years it lists.
Can I take the CCDS exam online?
IBHRE lists only PSI test centers. Candidates without a nearby center may need to travel.
How often is the CCDS exam offered?
Once a year. Plan your application around IBHRE's deadline, which is months before the exam.
Official sources
Practice tests for these certifications
This guide is general information, checked November 2026, not legal advice. IBHRE rules change; confirm with IBHRE before you apply.
