MA262 ELECTROCARDIOGRAPHY CLINIC
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1 MA262 ELECTROCARDIOGRAPHY CLINIC Course Objectives Upon successful completion of this course, the student will be able to: 1. Describe the structures of the heart and how they function; 2. Describe the cardiac cycle;. Determine intervals on rhythm strips; 4. Identify the different types of leads associated with electrocardiography; 5. Troubleshoot EKG issues; 6. Calculate heart rate; 7. Follow steps for interpreting rhythms; 8. Examine leads for rhythms originating in the sinus node; 9. Examine leads for rhythms originating in the atria; 10. Examine leads for rhythms originating in the AV junction; 11. Assess rhythms originating in the ventricles; 12. Identify types of AV blocks; 1. Follow steps to interpreting a 12-lead EKG; 14. Assess myocardial infarctions from EKG leads; 15. Explore medications and electrical therapy; 16. Identify appropriate stress tests and signs and symptoms of stress. Learning Unit 1 Objectives: 1, 2,, 4 Time In-Class Time Out-Of-Class Course Introduction and Overview Chapter 1: Coronary Anatomy and Physiology Chapter 2: Electrophysiology Chapter : Lead Morphology and Placement Blood Flow Valves Chambers Cardiac Cycle Arteries Sympathetic and Parasympathetic Nervous Systems Fight-or-flight and Rest-and-digest (Obj 1, 2) Polarized, Depolarization, and Repolarization Action Potential Transmembrane Potential Absolute and Relative Refractory Periods Waves and Complexes Intervals Pacemakers Escape and Usurpation Arrhythmia Node Failure Electrodes Bipolar and Augmented Leads Einthoven s Law Precordial Leads Chapter 1: Coronary Anatomy and Physiology (pp. 2-10) (Obj 1, 2) Chapter 2: Electrophysiology (pp. 1-26) Chapter : Lead Morphology and Placement (pp. -40) (Obj, 4) 1
2 Continuous Monitoring Electrocardiographic Truths QRS Complex Deflections (Obj, 4) Topics may include: blood flow; valves; chambers; cardiac cycle; arteries; sympathetic and parasympathetic nervous systems; fight-or-flight and rest-and-digest; polarized, depolarization, and repolarization action potential; transmembrane potential; absolute and relative refractory periods; waves and complexes; intervals; pacemakers; escape and usurpation; arrhythmia; node failure; electrodes; bipolar and augmented leads; Einthoven s law; precordial leads; continuous monitoring; electrocardiographic truths; and QRS complex deflections. (Obj 1,2,, 4) Critical Thinking Exercises (p. 12) Intervals Practice (p. 27) Critical Thinking Exercises (p. 4) Lead Morphology Practice (p. 41) (Obj 1,2,, 4) 6-7 Homework/Assignments: Practice Quiz (p. 11) Write a 2- page paper on the factors that affect the cardiac cycle. (Obj 1, 2) Practice Quiz (p. 1) Critical Thinking Exercises (p. 2) Practice Quiz (p. 42) (Obj, 4) 1-2 Project Research/Preparation: Lesson 1: Topic and approval (not required) Exam Unit 1 (Obj 1, 2,, 4) (Obj 1, 2,, 4) Lesson 1: Topic and approval (Obj 1, 2,, 4) Learning Unit 2 Objectives: 5, 6, 7, 8 Time In-Class Time Out-Of-Class Review Homework and Unit 1 Exam Chapter 4: Technical Aspects of the EKG Chapter 5: Calculating Heart Rate Chapter 6: How to Interpret a Rhythm Strip Chapter 7: Rhythms Originating in the Sinus Node -4 Chapter 4: Technical Aspects of the EKG (pp. 44-5) Chapter 5: Calculating Heart Rate (pp ) (Obj 5,6) Chapter 6: How to Interpret a Rhythm Strip (pp ) 2
3 Chapter 8: Rhythms Originating in the Atria Electrical Safety Artifacts Real Rhythm Digital Converter Macroshock and Microshock Heart Rate Rhythm Regularity (Obj 5,6) Rhythm Interpretation Sinus Rhythms Bradycardia Tachycardia Arrhythmia Sinus Arrest Sinus Exit Block (Obj 7,8) Topics may include: electrical safety, artifacts, real rhythm, digital converter, macroshock and microshock, heart rate, rhythm regularity, rhythm interpretation, sinus rhythms, bradycardia, tachycardia, arrhythmia, sinus arrest, and sinus exit block. Chapter 7: Rhythms Originating in the Sinus Node (pp ) (Obj 7,8) 5-6 Homework/Assignments: Practice Quiz (p. 5) Practice Quiz (p. 65) Critical Thinking Exercises (p. 54) Critical Thinking Exercises (p. 65) (Obj 5,6) Practice Quiz (p. 70) Practice Quiz (p. 88) Critical Thinking Exercises (p. 88) (Obj 7,8) (Obj 5,6,7,8) Practice Strips: Regularity of Rhythms (p. 59) Practice Strips: Calculating Heart Rate (p. 62) The Five Steps Practice (p. 67) Practice Strips: Sinus Rhythms (p. 79) (Obj 5,6,7,8) 2-4 Project Research/Preparation: Lesson 2: Outline and sources (not required) Exam Unit 2 (Obj 5, 6, 7, 8) (Obj 5, 6, 7, 8) Lesson 2: Outline and sources (Obj 5, 6, 7, 8)
4 Learning Unit Objectives: 9, 10 Time In-Class Time Out-Of-Class Review Homework and Unit 2 Exam Chapter 8: Rhythms Originating in the Atria Chapter 9: Rhythms Originating in the AV Junction Atrial Rhythms Atrial Flutter and Fibrillation Supraventricular Tachycardia Treatment Junctional Rhythms Premature Junctional Complexes High, Low, and Midjunctional Impulses Topics may include: atrial rhythms; atrial flutter and fibrillation; supraventricular tachycardia; junctional rhythms; premature junctional complexes; and high, low, and midjunctional impulses. Chapter 8: Rhythms Originating in the Atria (pp ) Chapter 9: Rhythms Originating in the AV Junction (pp ) 4-5 Homework/Assignments: Practice Quiz (p. 109) Practice Quiz (p. 122) Critical Thinking Exercises (p. 109) Critical Thinking Exercises (p. 122) Practice Strips: Atrial Rhythms (p. 100) Practice Strips: Junctional Rhythms (p. 116) 6-8 Project Research/Preparation: Lesson : Rough draft (not required) Exam Unit Lesson : Rough draft Learning Unit 4 Objectives: 11, 12 4
5 Time In-Class Time Out-Of-Class 1 Review Homework and Unit Exam Chapter 10: Rhythms Originating in the Ventricles Chapter 11: AV Blocks Ventricular Rhythms Premature Ventricular Complexes Agonal Rhythm Torsades de Pointes Asystole Wolff-Parkinson-White Syndrome Types of AV Blocks AV Node Bundle Branches 1-2 Chapter 10: Rhythms Originating in the Ventricles (pp ) Chapter 11: AV Blocks (pp ) Topics may include: premature ventricular complexes, ventricular rhythms, agonal rhythm, torsades de pointes, asystole, Wolff-Parkinson-White Syndrome, types of AV blocks, AV node, and bundle branches. -4 Homework/Assignments: Practice Quiz (p. 146) Critical Thinking Exercises (p. 147) Practice Quiz (p. 165) Critical Thinking Exercises (p. 166) Practice Strips: Ventricular Rhythms (p. 17) Practice Strips: AV Blocks (p. 156) 6-8 Project Research/Preparation: Lesson 4: Peer review (not required) Exam Unit 4 Lesson 4: Peer review Learning Unit 5 Objectives: 1, 14 5
6 Time In-Class Time Out-Of-Class Review Homework and Unit 4 Exam Chapter 1: How to Interpret a 12-Lead EKG Chapter 14: Myocardial Infarction Steps to Interpretation Axis Quadrant Bundle Branch Blocks Hemiblocks Ventricular Hypertrophy Miscellaneous Effects STEM and NSTEM Elevation Symptoms The Three Ls of Infarction Abnormalities Q Waves R Wave Progression Transition Zone -4 Chapter 1: How to Interpret a 12-Lead EKG (pp , , ) Chapter 14: Myocardial Infarction (pp ) Topics may include: steps to interpretation axis quadrant, bundle branch blocks, hemiblocks, ventricular hypertrophy, miscellaneous effects, STEM and NSTEM elevation, symptoms, the three Ls of infarction, abnormalities, Q waves, R wave progression, and transition zone. -4 Homework/Assignments: Practice Quiz (p. 299) Critical Thinking Exercises (p. 00) Practice Quiz (p. 2) Critical Thinking Exercises (p. ) BBB Practice (p. 278) Hypertrophy Practice (p. 291) MI Practice (p. 22) 6-8 Project Research/Preparation: Lesson 5: Final (not required) Exam Unit 5 Lesson 5: Final 6
7 Learning Unit 6 Objectives: 15, 16 Time In-Class Time Out-Of-Class 2 Review Homework and Unit 5 Exam Chapter 16: Medications and Electrical Therapy Chapter 17: Diagnostic Electrocardiography Antiarrhythmic Medication Digitalis and Adenosine Emergency Medications Pacemaker Components Cardioversion and Defibrillation AICD, AED, and Monitor/Defibrillators Therapeutic Hypothermia Pharmacologic Stress Test Treadmill Exercise Testing Bayes s Theorem and Reliability Specificity and Sensitivity Holter Monitoring Event Monitoring 2 Chapter 16: Medications and Electrical Therapy (pp , 76-77) Chapter 17: Diagnostic Electrocardiography (pp , 95-97) Topics may include: analyzing EKGs; antiarrhythmic medication; digitalis and adenosine; emergency medications; pacemaker components; cardioversion and defibrillation; AICD, AED, and monitor/defibrillators; therapeutic hypothermia; pharmacologic stress test; treadmill exercise testing; Bayes s theorem and reliability; specificity and sensitivity; Holter monitoring; and event monitoring. 2- Project Presentations: 5-6 Homework/Assignments: DDD versus VVI Practice (p. 70) Pacemaker Malfunctions Practice (p. 7) Practice Quiz (p. 78) Critical Thinking Exercises (p. 78) Stress Test Assessment Practice (p. 87) Practice Quiz (p. 98) Critical Thinking Exercises (p. 98) -4 Project Research/Preparation: Lesson 6: Class presentations (not required) Final Exam 7
8 Lesson 6: Class presentations 8
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