Official Course Description:   MCCCD Approval:  03/25/97
HCE140      19976-19995	LEC	3 Credit(s)	3 Period(s)
EKG and Arrhythmias
Comprehensive overview of cardiac anatomy and physiology including coronary artery function and basic cardiac health and disease. Identification of cardiacv arrhythmias using EKG wave form, measurement and relationship to cardiac activity, cardiac electrical and conductive systems. Comparative survey of variations and instrumentation of EKG use in cardiac specialties. Prerequisites: None.

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MCCCD Official Course Competencies:
HCE140   19976-19995	EKG and Arrhythmias

1.	Describe the anatomy of the heart, great vessels, and general cardiovascular system. (I)
2.	Describe the physiological processes governing the cardiovascular system. (II)
3.	Describe common pathophysiological conditions of the cardiovascular system. (III)
4.	Describe the electrophysiological conduction system of the heart involved in generation and transmission of impulses. (IV)
5.	Describe the common methods of obtaining electrical data from the heart for analysis. (V)
6.	List and describe the common methods of interpretation of electrical data obtained from the heart. (VI)
7.	Identify and name commonly encountered arrhyhmias. (VII)
8.	Describe Holter monitor recording and data analysis. (VIII)
9.	Describe function, method of operation and identification of commonly used pacemakers. (IX)
10.	Describe the procedure, rational, data collection, and interpretation of stress testing. (X)
11.	Identify traditional, current, and developmental EKG instrumentation. (XI)
12.	Demonstrate an understanding of common principles, techniques, potentials, and limitations of EKG testing. (XII)

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MCCCD Official Course Outline:
HCE140   19976-19995	EKG and Arrhythmias

I. Gross Anatomy A. Heart 1. Muscular chambers 2. Valve shape and location 3. Coronary circulation 4. Papillary muscle and chordae tendinae B. Great vessels 1. Arterial 2. Venous II. Physiological Processes A. Properties of cardiac muscle B. Cellular action potentials III. Common Pathophysiological Conditions A. Ischemia B. Necrosis C. Sympathetic nervous system effects D. Parasymphathetic nervous system effects E. Inappropriate cardiac cell membrane responsiveness IV. Electrophysiological Conduction System A. Sinoatrial (SA) node B. Atrioventricular (AV) node C. Bundle of His D. Purkinje cell network E. Intrinsic pacemaking ability F. Nervous stimulation of the heart G. Respiratory stimulation of the heart H. Normal depolarization I. Normal repolarization J. Refractory period V. Accumulation of Electrical Data A. Unipolar and bipolar leads B. Cardiac vectors and lead analysis C. Electrode continuity D. Three-, five-, and twelve-lead arrays E. Precordial and other specialty leads VI. Interpretation of Electrical Data A. Normal EKG configuration B. Normal sinus rhythm C. Definition of P, T, and QRS deflections D. Calculations of heart rate E. Meaning and duration of intervals F. Artifact identification VII. Commonly Encountered Arrythmias A. Fundamental identification 1. Inspection of EKG 2. Determination of dominant rhythm 3. Presence of P waves 4. Origin of QRS complex 5. Nature and origin of beats occurring out of cycle B. Disturbance of sinus impulse formation 1. Premature contraction 2. Bradycardia, tachycardia and arrhythmia 3. Sinus block 4. Sick sinus syndrome C. Atrial arrhythmias 1. Premature contractions 2. Tachycardia, flutter, fibrillation, and standstill D. Atrioventricular junctional arrhythmias 1. Premature contraction 2. Junctional escape beats and rhythm 3. AV dissociation 4. Echo beats and rhythm E. Ventricular arrythmias 1. Premature contractions 2. Tachycardia, flutter, fibrillation, escape, standstill, and parasystole F. Atrioventricular conduction disturbance 1. First degree AV block 2. Second degree AV block 3. Advanced AV block 4. Complete AV block 5. Bundle branch blocks G. Wolff-Parkinson-White syndrome (ventricular preescitation) 1. Occurence in general population 2. Prevention and treatment H. Bundle of His disturbances 1. AV conduction abnormalities 2. Intraventricular blocks VIII. Holter monitor recording A. Instructions to patient B. Indications and technical considerations C. Scanning and interpretation IX. Pacemakers A. Common models B. Mode of operation C. Battery life and capture D. Complications and malfunctions X. Exercise Electrocardiography (stress testing) A. Types of testing B. Pathophysiologic conditions C. Preparation of equipment D. Monitoring E. Precautions during testing XI. EKG Instrumentation A. Traditional clinical equipment B. Current new equipment C. Developmental microprocessor based equipment D. Computer use in EKG XII. Overview of EKG Testing A. Common principles B. Techniques for data accumulation C. Potential value of EKG D. Limitations of testing capabilities

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