UNIVERSITY EXPERT IN BASIC ELECTROCARDIOGRAPHY. II EDITION

Department of Clinical Medicine UMH

Fullscreen UMH Basic Electrocardiography Course

Contact

Location: University Miguel Hernández of Elche.

Campus of San Juan.

Departament of Clinical Medicine UMH

Mode: online

Telephone: +34 965 23 37 55

E-mail: malmarcha@umh.es

Secretary

MARISUN ALMARCHA ASENSIO

Secretary

[email protected]
Tel: +34 965 23 37 55

Department: Clinical Medicine

Branch of Education: Health Sciences

Pre-registration:  02/05/18 to 01/11/18

Enrolment: 01/09/18 to 10/11/18

Duration: 15/10/18 to 28/04/19

Hours: 200

Max students: 100

Min students: 24

Website: expertoecg.edx.umh.es

Download the information in PDF

Academic justification

Expert in Basic Electrocardiography II Edition

This course of University Expert in Basic Electrocardiography focuses on the more practical aspects for the realization and interpretation of the electrocardiogram.
The electrocardiogram is still one of the basic tools employed and most important in patient care, both in emergency and tracking queries, preoperative and hospitalization.

Health care professionals employ the electrocardiogram for the assessment of patients in many circumstances. Unlike what happened in the beginning of electrocardiography, when the electrocardiogram was a very specialized technique reserved for experts and people with very specific dedication, currently the realization of an electrocardiogram and its analysis lies with the doctors and nurses in almost any situation and position within the health care system.

Practically all of Electrocardiograms are performed by nurses, and many doctors are not properly trained to perform one correctly. On the other hand the majority of nurses has very limited interpretation of Electrocardiograms knowledge. In addition the main texts and courses are too basic or complex. We detected an area of interest that is not covered and may involve more professionals in the diagnosis and treatment of heart disease.

The general objective of this 2nd Edition basic electrocardiography course focuses on a basic aspect. These students can acquire the knowledge, skills and attitudes needed to perform and correctly interpret an electrocardiogram in the most important and frequent pathologies.
The course is designed to guide the problem-based learning.

Curriculum

Structure studies of Expert Course Basic electrocardiography Edition II.

This course has a duration of 200 hours and is composed of 5 modules:

Introduction to basic electrocardiography

This matter consists of 3 lessons. The first, called “Basic electrocardiography of the twenty-first century”, is an introductory lesson, which recalls the importance of the electrocardiogram in present-day medicine, in addition to teach how to use the platform and self-assessment.

The second lesson is titled “Power Bases of electrocardiography, and this are some concepts that although tedious. It is very useful for understanding the formation of the electrocardiogram and interpret a normal electro, as well as the main reviewed” alterations.

The final lesson of this module explains how to conduct an electrocardiogram correctly. This lesson, although simple, is essential, without a path in good condition the interpretation is impossible in some cases, and always difficult.

In particular in the Group of doctors is often a skill that is not acquired in the race, and is subsequently delegated entirely in nursing.

Paths interpretation

The matter is much more practical than the previous. It is divided into 5 lessons that will address specific topics of the electrocardiogram, following the logical order of interpretation of electro. In Lesson 4, we are going to review the correct identification of the heart rate, and heart rate calculation.

According to Lesson 5, we will devote to the P, corresponding with the atrial depolarization wave analysis. In lesson 6 we will deal with the atrioventricular conduction, the electrocardiogram is usually represented with the PR interval, and major alterations thereof will be addressed.

Lesson 7 studies alterations of the QRS, reflecting the alterations ventricular complex. And the last lesson of this module will discuss the ventricular Repolarization, including point J, ST segment and T wave and QT interval.

Rhythm disorders

According to the matter 3, the student will focus on the study of the heart rate, and major alterations. The first lesson, called “Bradyarrhythmias” reviewed the major changes that result in slow heart rhythms.

The second lesson of this matter (Lesson 10) is “Tachycardia with narrow QRS complex”, electrocardiogram examination is often sufficient to make a definitive diagnosis.

In Lesson 11 we will study “Tachycardias with QRS complex width”, with special emphasis on the differential diagnosis between ventricular and supraventricular tachycardias.

The final lesson of this matter is about electrocardiograms in patients with pacemakers, although the pacemaker is a complex world, the majority of Electrocardiograms can be interpreted easily following a systematic of proper interpretation.

At the end of the lesson, we are confident that the presence of stimulation of the pacemaker spikes will not be a barrier to interpret the electro.

Coronary heart disease

The contents consist of a single lesson, but of great importance. The electrocardiogram in coronary artery disease. Assayed values primary keys to the interpretation of electro in ischemic heart disease, both in acute phase chronic.

Faculty
  • Vicente Bertomeu González
  • Amaya García Fernández
  • Vicente Arrarte Esteban
  • Elisa Fontangordo Ponzoa
  • Javier Samper Llobregat
  Course code  Materia1

  Fin de las clases   Oct 30 2018

  Estimated effort  25 hours
  • Jesús Castillo Castillo
  • José Moreno Arribas
  • Vicente Bertomeu González
  • Domingo Orozco Beltrán
  • José María Lobos Bejarano
  Course code  Materia2

  Fin de las clases   Dec 26 2018

  Estimated effort  60 hours
  • Jesús Castillo Castillo
  • Pablo Peñafiel Verdú
  • Vicente Bertomeu González
  • Domingo Orozco Beltrán
  • Arcadi García Alberola
  Course code  Materia3

  Fin de las clases   Feb 7 2018

  Estimated effort  55 hours
  • Alberto Cordero Fort
  Course code  Materia4

  Fin de las clases   Mar 1 2019

  Estimated effort  20 hours

Electrocardiogram in special situations

In this matter we try aspects that have not been well reflected in the previous topics, how will affect some drugs the patient electrocardiogram, or the expression of the major electrolytic alterations.

The 15 lessons explain the main variations of electrocardiogram showing men women, children and secondary electrocardiographic changes to sports.

The last lesson of the course reviews the indications and the interpretation of the ambulatory electrocardiography, treating the hospital monitoring both the outpatient.

Final exam

Extraordinary call final exam

Faculty
  • Jesús Castillo Castillo
  • José Moreno Arribas
  • Vicente Ruiz Ros
  • Ricardo Ruiz Granell
  Course code  Materia5

  Fin de las clases   Oct 30 2018

  Estimated effort  40 hours
  • Jesús Castillo Castillo
  • José Moreno Arribas
  • Vicente Bertomeu González
  • Domingo Orozco Beltrán
  • José María Lobos Bejarano
  Course code  Materia12345

  Fin de las clases   Coming soon

  Estimated effort  200 hours

Bibliography

LESSON 1
-The rise of cardiovascular medicine. E Braunwald. European Heart Journal. 2012; 33-.838-846.
-Milestones in cardiovascular medicine: 10 or more? E.E. van der Wall. Neth Heart j 2013; 21:527-529.
-Electrocardiographic repolarization-related predictors of coronary heart disease and sudden cardiac deaths in men and women with cardiovascular disease in the Atherosclerosis Risk in Communities (ARIC) study. PM Rautaharju, ZM Zhang, WK Haisty Jr, AM Kucharska-Newton, WD Rosamond, EZ Soliman. Journal of Electrocardiology. 2015; 48:101-111.

LESSON 2
– Eyewitness to history: Landmarks in the development of computerized electrocardiography. Rautaharju PM. Journal of Electrocardiology 49 (2016) 1 ¿ Eyewitness to history: Landmarks in the development of computerized electrocardiography. Rautaharju PM. Journal of Electrocardiology 49 (2016) 1 ¿ 6.6.
– Recommendations for the Standardization and Interpretation of the Electrocardiogram. Kligfield P, Gettes LS, Bailey JJ, Childers R, Deal BJ, Hancock EW, van Herpen G, Kors JA, Macfarlane P, Mirvis DM, Pahlm O, Rautaharju P, Wagner GS, Josephson M, Mason JW, Okin P, Surawicz B, Wellens H, American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology, American College of Cardiology Foundation, Heart Rhythm Society. J Am Coll Cardiol 2007; 49:1109.
– What is inside the electrocardiograph?. Richard E. Gregg, Sophia H. Zhou, James M. Lindauer, Eric D. Helfenbein, Karen K. Giuliano. Journal of Electrocardiology. 2008;41:8-14.

LESSON 3
-Incorrect electrode cable connection during electrocardiographic recording. Velislav N. Batchvarov, Marek Malik, and A. John Camm. Europace (2007) 9, 1081¿1090.
-Automatic detection of ECG cable interchange by analyzing both morphology and interlead relations. Han C, Gregg RE, Feild DQ, Babaeizadeh S. J Electrocardiol. 2014;47(6):781-7.
-ECG Quiz. A tale of an abnormal ECG. Sahil Koppikar, Cathy Shaw, Adrian Baranchuk. Journal of Electrocardiology 47 (2014) 123-125.
-Identification of 4th intercostal space using sternal notch to xiphoid length for accurate electrocardiogram lead placement. Kevin Day, Isabel Oliva, Elizabeth Krupinski, Frank Marcus. Journal of Electrocardiology 2015:48;1058-1061.

LESSON 4
– The Architecture of the Sinus Node, the Atrioventricuiar Conduction Axis, and the Internodal Atrial Myocardium. Anderson RH, Ho SY. J Cardiovasc Electrophysiol. 1998;9(11):1233-1248.
– Sinus node revisited in the era of electroanatomical mapping and catheter ablation. Sánchez-Quintana D, Cabrera JA, Farré J, Climent V, Anderson RH, Ho SY. Heart. 2005;91(2):189-194.
– http://www.normalecg.org/
– Normal values of the electrocardiogram for ages 16-90 years. Rijnbeek PR, van Herpen G, Bots ML, Man S, Verweij N, Hofman A, Hillege H, Numans ME, Swenne CA, Witteman JC, Kors JA. J Electrocardiol. 2014;47(6):914-921.

LESSON 5
– Electrocardiogram in Right Atrial Enlargement. Reeves WC. JAm Coll Cardiol. 1987, 9 (2): 469-470.
– Evaluation of electrocardiographic criteria for right atrial enlargement by quantitative two-dimensional echocardiography. Kaplan JD, Evans GT, Foster E, Lim D, Schiller NB. J Am Coll Cardiol. 1994. 23 (3): 747-752.
– Left atrial size: physiologic determinants and clinical applications. Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, Tsang TS. J Am Coll Cardiol 2006;47:2357¿2363.
– The association of left atrial size and occurrence of atrial fibrillation: a prospective cohort study from the Canadian Registry of Atrial Fibrillation. Parkash R, Green MS, Kerr CR, Connolly SJ, Klein GJ, Sheldon R, Talajic M, Dorian P, Humphries KH; Canadian Registry of Atrial Fibrillation. Am Heart J. 2004 Oct;148(4):649-54.
– Relation of Electrocardiographic Criteria for Left Atrial Enlargement to Two- Dimensional Echocardiographic Left Atrial Volume Measurements. Lee KS, Appleton CP, Lester SJ, Adam TJ, Hurst RT, Moreno CA, Altemose GT. Am J Cardiol. 2007;99(1): 113-118.

LESSON 6
– Chapter 4: Atrioventricular conduction. Josephson Clinical Cardiac Electrophysiology. Josephson EM. Lippincott Williams And Wilkins; Edición: 5th edition (2017).
– Anatomy and electrophysiology of the human AV node. Kurian T, Ambrosi C, Hucker W, Fedorov VV, Efimov IR. Pacing Clin Electrophysiol. 2010 Jun 1;33(6):754-62.

LESSON 7
– AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. Surawicz B, Childers R, Deal BJ, Gettes LS, Bailey JJ, Gorgels A, Hancock EW, Josephson M, Kligfield P, Kors JA, Macfarlane P, Mason JW, Mirvis DM, Okin P, Pahlm O, Rautaharju PM, van Herpen G, Wagner GS, Wellens H; American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; American College of Cardiology Foundation; Heart Rhythm Society. J Am Coll Cardiol. 2009 Mar 17;53(11):976-81

– The role of ECG in the diagnosis of left ventricular hypertrophy. Bacharova L, Schocken D, Estes EH, Strauss D. Curr Cardiol Rev. 2014 Aug;10(3):257-61.
– Defining left bundle branch block in the era of cardiac resynchronization therapy. Strauss DG, Selvester RH, Wagner GS. Am J Cardiol. 2011 Mar 15;107(6):927-34.
– ECG manifestations in submassive and massive pulmonary embolism. Report of 4 cases and review of literature. Abarca E, Baddi A, Manrique R. J Electrocardiol. 2014 Jan-Feb;47(1):75-9

LESSON 8
– Pericardial Disease: Diagnosis and Management. Masud H. Khandaker, MD, PhD, Raul E. Espinosa, MD, Rick A. Nishimura, MD, Lawrence J. Sinak, MD, Sharonne N. Hayes, MD, Rowlens M. Melduni, MD, and Jae K. Oh, MD. Mayo Clin Proc. 2010 Jun; 85(6): 572¿593.
– 12-lead electrocardiogram features of arrhythmic risk: A focus on early repolarization. Rizzo C, Monitillo F, Iacoviello M. World J Cardiol. 2016 Aug 26;8(8):447-55.
– Repolarization syndromes. Bhatia A, Sra J, Akhtar M. Curr Probl Cardiol. 2012 Aug;37(8):317-62.

LESSON 9
– Sick sinus syndrome: Clinical manifestations, diagnosis, and evaluation. Homoud MK, Levy S, Downey BC. UpToDate 2017. www.uptodate.com.
– Bradiarritmias y bloqueos de la conducción. Vogler J, Breithardt G,Eckardt L. Rev Esp Cardiol (Engl Ed). 2012 Jul;65(7):656-67.
– 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. TheTask Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA), Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt OA, Cleland J, Deharo JC, Delgado V, Elliott PM, Gorenek B, Israel CW, Leclercq C, Linde C, Mont L, Padeletti L, Sutton R, Vardas PE. Rev Esp Cardiol (Engl Ed). 2014 Jan;67(1):58.

LESSON 10
– Utilidad del electrocardiograma de superficie para el diagnóstico de las taquicardias con QRS estrecho: correlación con los registros intracavitarios. David Hernández, José Santiago, Luis Colin, Pedro Iturralde, Milton Guevara y Jesús A. González-H. Rev Esp Cardiol. 2001;54:965-972
– The supraventricular tachycardias: Proposal of a diagnostic algorithm for the narrow complex tachycardias Carmelo Buttà, Antonino Tuttolomondo, Domenico Di Raimondo, Glauco Milio, Salvatore Miceli, Maria Tereza Attanzio, Lucia Giarrusso, Giuseppe Licata, Antonio Pinto. J Cardiol. 2013 Apr;61(4):247-55

LESSON 11
– A New Approach to the Differential Diagnosis of a Regular Tachycardia With a Wide QRS Complex. Brugada P, Brugada J, Mont L, Smeets J, Andries EW. Circulation 1991; 83: 1649-59.
– Ventricular tachycardia in coronary artery disease. Benito B, Josephson ME. Revista Española de Cardiología 2012; 65: 939-55.
– Current Algorithms for the Diagnosis of wide QRS Complex Tachycardias. Vereckei A. Current Cardiology Reviews. 2014;10:262-276.
– Clinical Utility of aVR – The Neglected Electrocardiographic Lead. Kireyev D, Arkhipov MV, Zador ST, Paris JA, Boden WE. Ann Noninvasive Electrocardiol. 2010;15:175-180.

LESSON 12
– Electrocardiographic Follow-Up of Biventricular Pacemakers. S. Serge Barold, Bengt Herweg y Michael Giudici. A.N.E. 2005;10(2):231¿255.
– Right Ventricular Outflow Tract Pacing: Radiographic and Electrocardiographic Correlates of Lead Position. Andrew D. Mcgavigan, Kurt C. Roberts-Thomson, Richard J. Hillock, Irene H. Stevenson, Harry G. Mond. PACE.
– Usefulness of the 12-lead electrocardiogram in the follow-up of patients with cardiac resynchronization devices. Part I. S. Serge Barold, Bengt Herweg Cardiology Journal. 2011, Vol. 18, No. 5, pp. 476¿486.
– Usefulness of the 12-lead electrocardiogram in the follow-up of patients with cardiac resynchronization devices. Part II. S. Serge Barold, Bengt Herweg Cardiology Journal. 2011, Vol. 18, No. 6, pp. 610¿624.
– Utility of the surface electrocardiogram for confirming right ventricular septal pacing: validation using electroanatomical mapping. Haran Burri, Chan-il Park, Marc Zimmermann, Pascale Gentil-Baron, Carine Stettler, Henri Sunthorn, Giulia Domenichini y Dipen Shah. Europace (2011) 13, 82-86.

LESSON 13
– Nueva terminología de las paredes del corazón y nueva clasificación electrocardiográfica de los infartos con onda Q basada en la correlación con la resonancia magnética. Antoni Bayés de Luna Rev Esp Cardiol. 2007;60(7):683-9.
– Location of Q-wave myocardial infarction in the era of cardiac magnetic resonance imaging techniques. Antoni Bayés de Luna. Journal of Electrocardiology. 2006;39:S79-S81.
– A New Terminology for Left Ventricular Walls and Location of Myocardial Infarcts That Present Q Wave Based on the Standard of Cardiac Magnetic Resonance Imaging. Antoni Bayés de Luna, Galen Wagner, Yochai Birnbaum, Kjell Nikus, Miguel Fiol, Anton Gorgels, Juan Cinca, Peter M. Clemmensen, Olle Pahlm, Samuel Sclarovsky, Shlomo Stern, Hein Wellens, Wojciech Zareba. Circulation. 2006;114:1755-1760.

LESSON 14
– Electrocardiographic manifestations: electrolyte abnormalities. Deborah B. Diercks, George M. Shumaik, Richard A. Harrigan, William J. Brady, Theodore C. Chan. The Journal of Emergency Medicine. 2004;27(2):153-160.
– Electrocardiographic Manifestations of Hyperkalemia. Amal Mattu, William J. Brady, David A. Robinson. American Journal of Emergency Medicine. 2000;18(6):721-729.
– ECG Manifestations: The Poisoned Patient. Christopher P. Holstege, David L. Eldridge, Adam Rowden. Emergency Medicine Clinics of North America. 2006;24(1):159-177.
– Utility of the Electrocardiogram in Drug Overdose and Poisoning: Theoretical Considerations and Clinical Implications. Christopher Yates, Alex F. Manini. Current Cardiology Reviews. 2012;8:137-151.

LESSON 15
– The normal ECG in childhood and adolescence. David F Dickinson. Heart 2005;91:1626-1630.
– Gender differences in the diagnosis and treatment of left ventricular hypertrophy detected by different electrocardiographic criteria. Findings from the SARA study. Vivencio Barrios, Carlos Escobar, Alberto Calderón, Sara Barrios, Josefa Navarro-Cid, Elena Ferrer, Rocio Echarri. Heart Vessels (2010) 25:51-56.
– The ECG in normal pregnancy. Joseph E. Carruth, Shirley B. Mirvis, Donna R. Brogan, Nanette K. Wenger. Am H Journal 1981; 6: 1075-1078.
– Comentarios a los nuevos criterios internacionales para la interpretación del electrocardiograma del deportista. Luis Serratosa-Fernández, Domingo Pascual-Figal, María Dolores Masiá-Mondéjar, María Sanz-de la Garza, Zigor Madaria-Marijuane, Juan Ramón Gimeno-Blanes y Carmen Adamuz, en representación del Grupo de Cardiología del Deporte de la Sociedad Española de Cardiología. Rev Esp Cardiol 2017; 70 (11):983-990.

LECCIÓN 16
– History of electrocardiology. The History of Clinical Holter Monitoring. Bruce Del Mar. Annals of Noninvasive Electrocardiography. 2005;10(2):226-231.
– http://www.bcguidelines.ca/pdf/ambulatory-ecg.pdf
– Ambulatory Arrhythmia Monitoring. Choosing the Right Device. Zimetbaum P, Goldman A. Circulation. 2010; 122:1629-1636.

Evaluation procedure

The theoretical part can be downloaded entirely by the student in PDF lessons and recommended bibliography. The practical part is based of clinical cases, videos and self-assessment questions. Questions of self-assessment will be carried out by the student at the end of each subject. It will be repeated up to 5 times for each student.

Tutorings will be send by email, as well as Forum of the subject and videoconference.

For each subject it has been established a regular evaluation period which is similar to the period of the subject taught, a week that overlaps with the next. This allows self-evaluations to adapt to the self-assessment of student’s learning. Self-assessments have been raised from a training point of view.
At the end of the title has been an extraordinary period of assessment where will be able to recover any of the pending matters.
There will be an exam with questions focused on paths of electrocardiography. They will be multiple answer about paths electrocardiographic, made by telematic way.
Final exam 100% qualification.

Use of facilities and temporary program

The course starts the 15/10/2018 and ends 28/04/2019 and is taught through the Platform http://edx.umh.es
At the beginning, the students will have a calendar which remembers the dates of opening and closing of each of the modules and lessons.

As it is an online course, it is not intended to the use of facilities at the UMH.

FACULTY

PROFESSOR POSITION AND INSTITUTION
Bertomeu González, Vicente Service of Cardiology University Hospital of San Juan de Alicante. Head of the Arrhythmias Unit of the University Hospital of San Juan de Alicante. Associate Professor Department of Clinical Medicine of the UMH.
Esteban Arrarte, Vicente Associate Professor Department of Clinical Medicine of the UMH. Area of Medicine. UNESCO Specialty: Cardiology
Carratalá Munuera, Concepción Assistant Doctor Professor, Department of Clinical Medicine of the UMH. Area of Medicine. Secretary of Family Medicine Chair UMH. Member of the Research Group: Valencian cardiometabolic Study
Castillo Castillo, Jesús Professor UMH. Service of Cardiology University Hospital Sant Joan d’Alacant
Lamb Fort, Alberto Professor UMH. Professor at the International Institute of Cardiology. Service of Cardiology University Hospital Sant Joan d’Alacant.
Fontangordo Ponzoa, Elisa Amalia Professor UMH. Nursing.
García Fernández Amaya Professor UMH. Service of Cardiology International Vithas Hospital Alicante.
García Alberola, Arcadio Professor UMH. Service Cardiology University Hospital  Virgen de la Arrixaca, Murcia.
Moreno Arribas, Jose Professor UMH. Cardiology Service University Hospital of San Juan de Alicante.
Orozco Beltran Domingo Associate Professor UMH. Department of Clinical Medicine of the UMH. Area of Medicine. University Chair in Obstructive Pulmonary Chronic Disease (EPOC). Co-Director of Chair and Director of the University Master’s Degree in Health Management. Director of research group: Cardiometabolic Valencian Study.
Peñafiel Verdú, Paul Professor UMH. FEA of Cardiology in University Hospital Virgen Arrixaca in Murcia.
Ruiz Granell, Ricardo Professor UMH. Head of Section of Cardioestimulacion of the Unit of Arrhythmias of the Clinical Hospital of Valencia.
Ros Ruiz, Vicente Professor UMH. Personal professor researcher holder at the University of Valencia. Department of Nursing.
Salar Alcaraz, María Eladia Professor UMH. Healthcare Network SMS: MurciaSalud. Región de Murcia

Access requirements to basic UMH Electrocardiography Course requirements

This course is offered to qualified University officials or students in the final year of the degree of Medicine, Nursing, Pharmacy and other Health Sciences Careers.
It will be necessary to send the relevant documents or certified photocopies for verification, as well as a letter of motivation and a CV.

Links of general interest of the Course of Basic electrocardiography

pre-registration and registration