Required cardiac cath lab competencies include ASD closures, cardiac implant closure device, cardiac stent placement, adult diagnostic catheterizations, IABP placement/removal, Impella insertion, interventional catheterizations, left heart catheterization, pacemaker/defibrillator lead extraction/removal, PCI, pulmonary artery line/Swan-Ganz monitoring, right heart catheterization, rotablator atherectomy, TAVR, transesophageal echocardiogram (TEE), valvuloplasty, ventricular assist device insertion, and Watchman procedure. Required professional knowledge/skills also include monitoring procedural sedation, obtaining 12-lead EKG/ECG, pressure ulcer assessment/prevention, radiation and laser safety, sheath removal/monitoring, topical hemostasis (D-Stat, Chito-Seal, Syvek Patch), vascular closure systems (Perclose, StarClose), and ventilator management.