Certified cardiographic technician (CCT)

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Image of nurse with patient, ecg in th background.

Exam format

According to Cardiovascular Credentialing International (CCI)'s official website, the Certified cardiographic technician (CCT) examination contains 130 multiple choice questions — 110 scored and 20 unscored — with a time limit of two hours. The test will include both traditional and innovative question types.

  1. Traditional multiple-choice — out of the four given options one is correct (e.g. A, B, C or D).
  2. Innovative multiple responses — there are four or six options, out of which the specified number is correct.
  3. Innovative hot spot — the test taker will be instructed to click on the correct part of an image to answer a question.
  4. Innovative drag and place — the test taker will be instructed to click and drag labels to the correct boxes or areas on an image. Some labels may be left unused.

Scoring of exam

Twenty of the CCT exam questions are unscored and these are unidentified and randomly distributed throughout the exam to get performance data. The exam score of the candidate is based on the answers of the 110 scored questions.

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Exam duration

The exam's total duration is 2 hours:

  • One hour and fifty minutes for the body of exam
  • Ten minutes for a pre-exam tutorial and post-exam survey

Contents of exam

The exam content is based on Job Task Analysis (JTA) findings, which describes all the tasks a CCT performs on the job and the general knowledge required to complete them. Subject matter experts in the cardiovascular profession develope the content. To keep the exams relevant to current practices in the field, JTA is performed every five years for all nine of the exams CCI offers. Professionals with a doctorate in industrial and organizational psychology conduct ongoing statistical analysis.

Average wages for related jobs

Cardiovascular technologists and technicians
Diagnostic Medical Sonographers
Certified cardiographic technician (CCT)
Source: Bureau of Labor Statistics and salaryexpert.com

Examination matrix and task list

The tasks stated below are the activities that CCT performs on the job, with the relative weight of the exam's content areas.

Duties and tasks Weighting
A. Conducting pre-procedural activities 10%
  1. Take doctor’s instructions
  2. Check doctor’s instructions
  3. Take universal precautions e.g. handwashing, personal protective equipment (PPE)
  4. Identify patient
  5. Gain patient's consent
  6. Transport patient
  7. Prepare the patient (shaving, cleaning the skin, etc.)
  8. Find physical landmarks
  9. Check patient's demographics
  10. Enter patient information into (electrocardiogram) EKG machine
  11. Identify patient safety hazards
B. Performing resting ECG (12-lead, 15-lead, etc.) 40%
  1. Assemble supplies and equipment
  2. Educate the patient on the procedure
  3. Apply electrodes to the patient
  4. Ensure equipment is calibrated
  5. Perform standard ECG
  6. Perform right side ECG
  7. Interpret ECG tracing
  8. Correlate ECG morphology with anatomy and physiology
C. Performing stress tests 20%
  1. Assemble stress test supplies and equipment
  2. Explain safety and protocol to patient
  3. Perform baseline ECG and take observations
  4. Confirm chosen stress test protocol
  5. Perform stress test
D. Performing ambulatory monitoring (holter, event, telemetry, transtelephonic, pacemaker, etc.) 5%
  1. Assemble ambulatory monitoring equipment
  2. Explain the procedure to the patient
  3. Check equipment functionality
  4. Attach leads to the patient (stress loops, pouch, etc.)
  5. Explain ambulatory monitoring requirements (limitations, expectations, duration, etc.)
E. Performing rhythm analysis 25%
  1. Interpret obtained data
  2. Correlate ECG results (waveforms, segments, intervals, etc.) with cardiac function
  3. Identify, report, and record results
Total 100%

General concepts that are required to perform the tasks identified

  • Heart
    • Size
    • Location
    • Structure
    • Chambers
    • Valves
  • Blood flow
  • Arteries
  • Veins
  • Capillaries
  • Arterioles
  • Venules
  • Cardiac valve functions
  • Pressures
  • Relationship of cardiac output to heart rate and stroke volume
  • Control mechanisms
  • Cardiac cycle
  • Normal values
  • Waveforms
  • ECG measurement
  • Bipolar, unipolar, and pre-cordial leads
  • Einthoven’s triangle and law
  • ECG calibration
  • Single- and three-channel ECG
  • Troubleshooting ECGs
  • Standardization
  • Paper speed
  • Lead placement
  • Electrical interference
  • Somatic tremor

Recommended books

CCI's official website recommends the following sources to help you prepare for the exam.

  1. Shier, David, Jackie Butler, and Ricki Lewis. Hole’s Essentials of Human Anatomy and Physiology. Boston: McGraw-Hill. Free eBook
  2. Dubin, Dale. Rapid interpretation of EKG’s: an interactive course. 6th ed. Tampa, Fla.: Cover Pub. Co., 2000. Free eBook
  3. Booth, Kathryn A., and Thomas E. O’Brien. Electrocardiography for Healthcare Professionals. New York: McGraw-Hill.
  4. Wagner, Galen S., and Henry J. L. Marriott. Marriott’s Practical Electrocardiography. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Certification renewal

According to the Cardiovascular Credentialing International (CCI) official website, a credential is active for 9–12 months (First time) and 3 Years (renewals) after passing a CCI exam. Need more information? Click below