Required Documentation

Completing the online questionnaire portion of the application is only part of the submission process. Certain additional items are also required in order to complete your application submission to the IAC.

All facilities are required to include the items listed below as part of the Online Accreditation application prior to hitting the submit button online (learn more about uploading attachments):

  • Facility Procedure Log – The facility must submit a log of all patients seen in the facility for cardiac electrophysiology procedures. The data for this log can come from appointment scheduling reports or compiled into our sample log»
    The information in the log MUST include the following: patient id, patient date of birth, indication for the procedure, procedure type, date of procedure, operator, department or specialty of operator and procedure complications. Pre- and post-procedure patient assessment, outcomes of the procedure and complications are optional.
      • If the facility performs at least 100 procedures over 12 months the IAC will request a procedure log from the previous 2 months, or more, to meet the minimum requirement of the most recent 30 consecutive cases for each testing section listed in the application.
      • If the facility performs fewer than 100 procedures over 12 months but at least one operator has performed at least 50, the IAC will request the procedure log from the previous 3 months, or more, to meet the minimum requirement of the most recent 30 consecutive cases. (If applying in Chronic Lead Extraction, please add the most recent 5 consecutive cases.)
  • Staff Information – Enter only staff members who perform the following cardiac electrophysiology procedures in the online application: testing and ablation; device implantation and/or chronic lead extraction. Comment: Documentation of all staff training and experience must be kept on file and available for review upon request, audit or site visit.
  • Protocol (All procedures that are performed outlining what is done pre-, during and post-procedure):
    • Cardiac Electrophysiology Testing and Ablation*
    • Device Implantation
    • Chronic Lead Extraction*
    • Left Atrial Appendage Occlusion (LAAO)* 

      *Not applicable when applying for Device Implantation only
  • Quality Improvement Policy (sample)
  • Quality Improvement Meeting Minutes (sample)

PLEASE NOTE: Other documentation (policies, protocols, licenses, etc.) MUST BE KEPT ON FILE for review at the time of the site visit. For a complete list of what will be reviewed during the site visit, download the Site Visit Checklist»

For complete details on these requirements, please review the IAC Standards and Guidelines for Cardiac Electrophysiology Accreditation.