Exam Certification


2018 Exam

Registration will be open in December 2017 for the 2018 Exam.

2017 Exam

Congratulations to all those who completed the BHRS 2017 Exam. Results have been emailed to candidates*.

*please note that BHRS does not disclose an individual's exam mark or overall pass mark.


2016 Certification Exam Pass Marks

Please note, pass marks vary slightly from examination to examination to take account of the relative difficulty of examinations presented to candidates, ensuring that the pass standard remains constant. 

The pass mark is determined by a 'standard setting' process. 

In 2016, 136 candidates sat the Core section with the vast majority passing.  The median mark is shown below for each section of the 2016 exam.  Please note the median mark IS NOT the pass mark.

Core       57%   n=136
Devices  57%   n=133
EP          58%   n=10
Clinical   55%   n=5

All candidates who reach the required standard for the appropriate exam will pass, however it has been and continues to be the decision / policy of the BHRS Council not to disclose the actual pass mark or to enter discussions with individual candidates about their marks / examination performance.

Further details about the 2016 exam can be found within the BHRS Certification 2016: An Overview presentation document.

What is British Heart Rhythm Society Certification?

British Heart Rhythm Society Certification is a recognition of knowledge and practical experience in the field of cardiac rhythm management.  It consists of two components: the examination and a logbook or written case work.  The certificate is awarded on successful completion of the examination and submission of the appropriate logbook.

The Examination

The examination was first introduced in 1999 as part of the BPEG Certificate of Competency.  In 2006 the examination became the Heart Rhythm UK Certificate of Accreditation and structure of the examination was revised, with the introduction of core and specialist sections.

In 2011, the examination paper was marked electronically for the first time.  Since then, the questions and candidates responses have been evaluated in detail so that we can continue to improve the quality, relevance and validity of the questions.

In 2013, the number of questions was increased to 120 (60 core and 60 specialty), in part, to bring the examination into line with the EHRA examination.  As a consequence, the duration of the examination was increased to 4 hours.  Also in 2013, we introduced a third “clinical” specialist section.  This section is aimed at nurses with a special interest in CRM and is complimented by a new “logbook equivalent” of case discussions. It was not felt appropriate that nurses with a special interest in CRM complete a logbook, instead there is a requirement to complete a number of case studies.

Exam Question Breakdown 2017

Section 1: Core

Core Sub-Sections Number of Questions
1.1 Anatomy/Physiology/Clinical Assessment 8
1.2 Arrhythmias - Diagnosis/ECGs 10
1.3 Devices (Inc. clinical trials)  15
1.4 Electrophysiology (Inc. clinical trials) 15
1.5 Guidelines/DVLA/MHRA 6
1.6 Pharmacology 6

Section 2: Devices

Devices Sub-Sections Number of Questions
2.1 Pacemaker biophysics & physiology 7
2.2 Device indications & modes 10
2.3 Pacemaker follow-up, troubleshooting, CXR 15
2.4 Cardiac Resynchronisation Therapy 10
2.5 Implantable Cardioverter Defibrillators 10
2.6 ECGs/Infection/Lead extraction/ILR 8

Section 3: Electrophysiology

EP Sub-Sections Number of Questions
3.1 Basic EP (genetics, channels, drugs, clinical) 10
3.2 General concepts: Catheter position, access, signals, filter-setting.  Intervals, block/gap, Arrhythmia mechanism - Pacing manoeuvres 10
3.3 Invasive electrophysiology - standard atrial arrhythmias (SVT, typical flutter) 15
3.4 Invasive electrophysiology - complex atrial arrhythmias (AF, atypical flutter, atrial tachycardia) 10
3.5 Invasive electrophysiology - complex ventricular arrhythmias (scar related, non-scar related, PVCs) 10
3.6 Invasive electrophysiology - Specific ablation aspects: lesion formation, energy sources.  Complications & Imaging mapping systems 5

Section 4: Nursing/Clinical

Nursing Sub-Sections Number of Questions
4.1 Clinical assessment/Guidelines 10
4.2 Arrhythmias - Diagnosis/Mechaniss/ECG 15
4.3 Pharmacology 10
4.4 Syncope diagnosis and treatment 5
4.5 Devices (Pacemaker/CRT/ICD) 10
4.6 Electrophysiology 10

Exam Syllabus and Reading List

Please click here to download the syllabus.  A recommended reading list is also available for download by clicking here.

Sample Exam Questions

For any potential candidate considering taking the exam in the future, you may find it useful to view the below representative questions for the devices and EP sections:

Exam Answer Sheet Guidance

Since 2011, the examination papers have been marked electronically. This allows British Heart Rhythm Society to be able to examine the questions and candidates responses in more detail, so that we can work to improve the quality and validity of the questions. It is therefore essential that candidates are aware of how they are required to mark their answers on the exam answer sheets. Please click here to download the guidance.

The Logbooks

In order to achieve British Heart Rhythm Society Certification, candidates must complete and submit a logbook.  There are 2 logbooks.  You complete ONE logbook only.

NEW FROM 2014:  From January 2014, the logbook must be completed over a 2 year period, during which time candidates must take and pass the BHRS examination.  Candidates need to notify BHRS via email that they wish to commence their logbook.  Once your logbook registration has been acknowledged, candidates can start to complete their logbooks. 

If at the time you register for the exam, you are yet to notify BHRS you wish to commence your logbook, you will need to do this before exam registration closes. For example, all 2017 exam candidates need to have informed BHRS they wish to start their logbook before Friday 24th February 2017Notifications after this date will not be accepted and your logbook start date will default to Friday 24th February 2017. 

Retrospective data is not permitted.  Candidates have 2 years, from the agreed date of registration, to complete their logbook.  Unless there are exceptional circumstances, no extension to this period will be considered.  

Both doctors and physiologists should complete the same logbooks.  Nurses with a special interest in CRM have their own logbook equivalent. 

The logbook component is very important and requires a significant amount of time and effort to complete.  A candidate who does not specialise in cardiac rhythm management will find it difficult to complete the logbook within the specified deadline.  The Certification Committee would expect candidates to have a minimum of two years experience in cardiac rhythm management prior to sitting the examination or completing the logbook.

In some cases, a candidate may be required to apply for an honorary contract to enable them to visit other hospitals to undertake procedures and collate data for their logbook and this additional time must be factored in when completing a logbook.

Devices Logbook

Electrophysiology Logbook

Nurses Clinical Logbook equivalent Case Studies Guidelines

You complete ONE logbook only and it is recommended that the logbook should not exceed one A4 lever-arch folder in size.  If you have any technical problems trying to view/download the logbook(s) please get in contact:

Tel: +44 (0) 1789 867 526
E-mail: admin@bhrs.com

Please note that all patient identifiable information must be anonymised in the logbooks. Inclusion of any patient identifiable information is a clear breach of patient confidentiality and a serious governance issue.  Markers have been instructed to return logbooks and fail candidates if they have patient identifiable information in their logbooks.

Once you have completed your logbook, please send it to:

British Heart Rhythm Society
Unit 6B
Essex House
Cromwell Business Park
Chipping Norton

Please note: we strongly advise that you send your logbook using a tracked postal service.

Logbook Extensions

Requests for logbook extensions must always be submitted via email (and not by telephone) to admin@bhrs.com, giving full reasons why an extension is being sought.  Requests will then be considered on a case by case basis by the Certification Committee.  Please note that extension requests require clear mitigating circumstances (e.g. ill-health, pregnancy).  Extensions will not be given for candidates who have failed to achieve the requisite number or type of cases.

New from 2014

In 2014, with the change in identity of the organisation, the process was re-branded as British Heart Rhythm Society Certification.

From 2014, in order to undertake the certification process (examination and logbook), candidates must be members of the British Heart Rhythm Society. You must also remain a member of the Society in order to maintain Certification.

BHRS Certification Recognised at Masters' Level

The School of Health and Social Care at Teesside University has agreed to recognise the British Heart Rhythm Society (BHRS) Certification.  Candidates who successfully complete the BHRS Certificate will be able to gain exemption from the module ‘Arrhythmia Management’ (AHH4002-N) at Teesside University (30 credits at Masters Level) and thus transfer these credits into the following programmes:

  • MSc Advanced Clinical Practice
  • MSc Nursing
  • PG Dip Surgical Care Practitioner

This exemption applies to all candidates who have successfully received BHRS Certification since 2008 (candidates must have passed both the exam and logbook).  This also only applies to candidates who have received Certification for the first time, not candidates who have Re-certified. 

Applications for Recognition of Prior Learning (RPL) for other postgraduate programmes at Teesside University will be considered where appropriate.  Other universities may consider these academic credits for RPL experience purposes upon application.

To apply, please contact the programme lead for the MSc Advanced Clinical Practice or MSc Nursing via the School of Health Switch board on 01642 384 100.

British Heart Rhythm Society Certification for Employees of Medical Devices or EP Equipment Companies

In 2013, Heart Rhythm UK Council decided to introduce a pilot of “Heart Rhythm UK Certification.”  Only individuals who are employed by a cardiac devices manufacturer, a manufacturer of EP equipment or other related company are eligible to apply.  This will continue in 2014 as British Heart Rhythm Society Certification (Industry).  Candidates can obtain this Certification on successful completion of the British Heart Rhythm Society examination (including the relevant devices or EP specialty section).  This option is not available to NHS or private sector employees such as nurses, physiologists or doctors, who must complete full Certification, including a logbook.

This option is being piloted as it is appreciated that many industry employees would be interested in undertaking full British Heart Rhythm Society Certification but would find it difficult to comply with the requirements of the logbook.

Candidates from industry who have successfully completed the two sections of the examination in the last three years (2011 – 2013) can apply to British Heart Rhythm Society for retrospective recognition and award.

Depending on the success of the pilot, this may be continued after 2014.

Post-nominal Letters

Post-nominal letters, also called post-nominal initials or post-nominal titles, are letters placed after the name of a person to indicate that the individual holds a position, educational degree, accreditation, office, or honour.

Following successful completion of BHRS accreditation no post nominal is awarded (although the BHRS Certification Committee is aware that numerous individuals use unofficial post nominal letters).


In January 2014, the Certification Committee agreed to a process of re-certification to bring BHRS in line with European and US examinations.  This has subsequently been ratified by Council.

BHRS Certification will now be valid for 10 years.  Candidates will need to successfully re-sit the examination after 10 years in order to maintain Certification.  However, there will not be a requirement to repeat the logbook.

IMPORTANT:  Candidates who sat the examination in 2006 and subsequent years will also be required to re-certify.  However, it was agreed that these candidates would also have a 10 year period from 2014 in which to re-certify i.e. candidates who successfully gained Heart Rhythm UK Accreditation from 2006 – 2013, inclusive, will be required to re-certify by 2024.

Candidates who successfully passed the examination and logbook prior to 2006 in the old format will not be required to re-certify.

For all candidates to remain certified, they are required to be members of BHRS.

Click here to view the full guidelines to support BHRS re-certification.

All available courses and presentations from conference days at Heart Rhythm Congress can be sourced here: http://www.heartrhythmcongress.com/scientific-programme

If you have any further queries about BHRS Certification and its different components, please check out our Certification FAQs or contact us at admin@bhrs.com or +44 (0) 1789 867 526.