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Dr. Braith: APK 6128, EKG Interpretation, Fall Semester, 2012 College of Health and Human Performance Department of Applied Physiology & Kinesiology SYLLABUS APK 6128 EKG INTERPRETATION FALL SEMESTER, 2012 Instructor: Office: Office Hours: Phone: Email: Textbooks: Textbooks: Dr. Randy Braith Rm. 142 FLG Thursday 11:00am-12:30pm; Friday 11:00am-12:30pm; and by appointment 294-1722 [email protected] Required (1) Fast & Easy ECGs: A Self-Paced Learning Program; Shade and Wesley, McGraw Hill Publisher Optional Reference/Supplemental Texts (1) RAPID INTERPRETATION of EKG’S, Dale Dubin, 6th ed., Cover Publishing (2) BASIC DYSRHYTHMIAS: INTERPRETATION & MANAGEMENT, Robert J. Huszar, 2nd Edition, Mosby Lifeline Publishing (3) ECG INTERPRETATION, Ken Grauer, 2nd Ed., Mosby Publisher COURSE DESCRIPTION: Graduate course in Exercise Physiology for students interested in human research, rehabilitative or health promotion emphasis, or clinical professions. The course offers lecture study of basic and intermediate electrocardiography, including cardiac function, lead systems, rate, arrhythmias, axis, infarction, ischemia, hypertrophy, effects of cardiovascular drugs and exercise on the electrocardiogram. COURSE OBJECTIVES: Upon completion of the course, the student should be able to achieve the following: 1. 2. 3. 4. 5. Describe basic principles of cardiac electrical activity. Describe basic principles of electrocardiography. Recognize EKG correlates of ischemic heart disease and infarction. Identify and describe prominent cardiac arrhythmias. Describe the effects of “first line” cardiovascular drugs on the electrocardiogram. GRADING PROCEDURES & COURSE REQUIREMENTS: 1. There will be 3 examinations (200 pts each). 2. The first exam will include multiple choice, true/false, and short essay questions. 3. The second exam will include multiple choice, true/false, short essay questions, and EKG strip interpretation. 4. The third exam (Final Exam) will include only EKG strip interpretation. 5. Practice EKG strips will be reviewed on numerous occasions in class prior to lecture. 1 Dr. Braith: APK 6128, EKG Interpretation, Fall Semester, 2012 GRADING SCALE A = 540-600 points B+ = 516-539 points B = 480-515 points C+ = 456-479 points C = 420-455 points D+ = 391-419 points D = 360-390 points F = less than 360 points EXAMS Exam #1 Exam #2 Exam #3 Total Points = = = = POINTS 200pts 200pts 200pts 600pts GRADING NOTE: Although the University Registrar now recognizes minus grades, we will follow the traditional grading scale unless there are any objections. http://www.registrar.ufl.edu/catalog/policies/regulationgrades.html Final course grades will be provided by the University Registrar. STUDENTS REQUIRING SPECIAL ACCOMODATIONS FOR EXAMS NOTE: “Students requesting special classroom accommodations must first register with the Dean of Students Office. The Dean of Students Office will provide documentation to the student who must then provide this documentation to the instructor when requesting accommodation.” DISABILITY RESOURCE CENTER NOTE: “For optimal consideration, you must see the Professor within the first three (3) days of class.” ACADEMIC HONESTY NOTE: Cheating on exams in any fashion will not be tolerated. This will result in a “zero” for that exam and possibly for the course and subject to consequences outlined in the Student Handbook. Students are expected to adhere to UF student honor code: “We, the members of the University of Florida community, pledge to hold ourselves and our peers to the highest standards of honesty and integrity.” EXTRA CREDIT NOTE: Extra credit assignments will not be given to improve grades. MAKE-UP EXAMS NOTE: There will be no make-up exams without prior approval of instructor. PRACTICE SESSIONS: APK 6128 is designed to be primarily a lecture course. However, one or more class periods will be dedicated to “hands-on” laboratory experience performing standard 12 lead EKGs on classmates. (1) Each student in APK 6128 will receive a resting 12 lead EKG and each student will prepare a classmate for a standard 12 lead EKG procedure. (2) Additionally, all students will have the opportunity throughout the semester to practice EKG recognition skills in the laboratory using an EKG simulator. The simulator is an excellent tool to assist students in the ‘real-time’ recognition of potential health-endangering arrhythmia’s. (3) Practice interpreting EKG strips is also available online at “Practice EKG Strips” 2 Dr. Braith: APK 6128, EKG Interpretation, Fall Semester, 2012 COURSE OUTLINE APK 6128 EKG INTERPRETATION TOPIC TEXT ELECTRICAL ACTIVATION OF THE HEART - Depolarization - Repolarization - Sodium-Potassium ATP Pump - Automaticity - Action Potential Phases - Calcium Channels Fast/Easy Chap. 1 p.19-31 PACEMAKER AND CONDUCTION SYSTEM OF THE HEART - Sinus Node - SinoArtrial Pathways - Atrioventricular Node - Atrioventricular Nodal Pathway - Bundle Branch Pathways - Purkinji Fibers - Escape Rhythms - Overdrive Suppression Fast/Easy Chap. 1 p. 32-38 THE ELECTROCARDIOGRAM LEADS - History of Lead Names - Einthoven’s Triangle - Limb Leads - Bipolar Limb Leads - Unipolar Limb Leads - Precordial Leads - Placement of Electrodes for Multichannel Monitoring Fast/Easy COMPONENTS OF THE NORMAL ELECTROCARDIOGRAM - EKG Paper - P Wave - PR Interval - QRS Complex - ST Segment - T Wave - QT Interval - U Wave Fast/Easy Chap. 2 p. 47-54 MEASUREMENT OF HEART RATE - Calculation of Heart Rate Fast/Easy Chap. 2 p. 80-98 3 CHAPTER Chap. 2 p. 56-70 Placement Handout Dr. Braith: APK 6128, EKG Interpretation, Fall Semester, 2012 MECHANISMS OF ELECTRICAL ARRHYTHMIAS - Altered Automaticity - Triggered Activity - Reentry SINUS NODE ARRHYTHMIAS - Normal Sinus Rhythm - Sinus Tachycardia - Sinus Bradycardia - Sinus Arrhythmia Fast/Easy Chap. 8 p. 244-256 ATRIAL ARRHYTHMIAS - Premature Atrial Complexes - Atrial Tachycardia - Atrial Fibrillation - Risk & Treatment of Atrial Fibrillation - Atrial Flutter Fast/Easy Chap. 9 p.267-285 JUNCTIONAL ARRHYTHMIAS - Premature Junctional Complex - Junction Escape Beat - Junction Rhythm - Junction Reentry Rhythm - Wolff-Parkinson-White and Preexcitation Syndromes - Radiofrequency Ablation Fast/Easy Chap. 10 p. 299-310 Fast/Easy Chap. 14 p. 445-447 ATRIOVENTRICULAR BLOCK - First Degree AV Block - Second Degree AV Block (Type I and Type II) - Third Degree AV Block - Atrioventricular Dissociation Fast/Easy Chap. 12 p. 364-376 VENTRICULAR BUNDLE BRANCH BLOCK - Left Bundle Branch Block - Right Bundle Branch Block - Hemiblock Fast/Easy Chap. 14 p. 435-444 PREMATURE VENTRICULAR COMPLEXES - Premature Ventricular Complexes - Full Compensatory Pause - Overdrive Suppression - Unifocal vs Multifocal PVCs - Bigeminy, Trigeminy, Quadrigeminy - Couplets, Triplets - R-on-T Phenomenon Fast/Easy Chap. 11 p. 327-338 4 Dr. Braith: APK 6128, EKG Interpretation, Fall Semester, 2012 - Aberration vs Ectopy VENTRICULAR TACHYCARDIA & FIBRILLATION - Mechanism - Defibrillation - Pharmacological Management - Torsades de Pointes Fast/Easy ELECTROPHYSIOLOGY STUDY (EP) Lecture Notes ISCHEMIA & MYOCARDIAL INFARCTION - ST Segment Changes of Ischemia - ST Segment Changes of Acute Infarction - T-Wave Inversion - Abnormal (Significant) Q Waves - Locating The Infarct - Left Bundle Branch Block and Myocardial Infarction Fast/Easy Chap. 15 460-486 DETERMINATION OF ELECTRICAL AXIS - Vectors and Axis of the Normal Heart - Axis at a Glance - The Quadrant Method - Exercises for Axis Determination - Left Axis Deviation - Right Axis Deviation - Extreme Right Axis Deviation Fast/Easy Chap. 13 p. 394-407 CARDIAC ANTI-ARRHYTHMIC DRUGS Lecture Notes 5 Chap. 11 p. 340-346