Cardiac Electrophysiology
Cardiac Electrophysiology
Information Covered:
- Electrophysiology
- Characteristics of myocardial cells
- Automaticity
- Excitability
- Conductivity
- Contractility
- Electrical potential
- Action potential – important electrolytes
- Sodium
- Potassium
- Calcium
- Chloride
- Magnesium
- Excitability
- Thresholds
- Depolarization
- Repolarization
- relative refractory period
- absolute refractory period
- Neurotransmitters
- Acetycholine
- effects on myocardium
- effects on systemic blood vessels
- Cholinesterase
- effects on myocardium
- effects on system blood vessels
- Acetycholine
- Action potential – important electrolytes
- Characteristics of myocardial cells
- Electrocardiographic (ECG) monitoring
- Electrophysiology and wave forms
- Origination
- Production
- Relationship of cardiac events to wave forms
- Intervals
- Normal
- Clinical significance
- Segments
- Leads and electrodes
- Electrode
- Leads
- Anatomic positions
- Correct placement
- Surfaces of heart and lead systems
- Inferior
- Left lateral
- Anterior/ posterior
- Artifact
- Standardization
- Amplitude
- Height
- Rate
- Duration
- Wave form
- Segment
- Complex
- Interval
- Wave form analysis
- Isoelectric
- Positive
- Negative
- Calculation of ECG heart rate
- Regular rhythm
- ECG strip method
- "300"/triplicate method
- Irregular rhythm
- ECG strip method
- "300"/triplicate method
- Regular rhythm
- Lead systems and heart surfaces
- ECG rhythm analysis
- Value
- Limitations
- Heart surfaces
- Inferior
- Left lateral
- Precordial
- Acute signs of ischemia, injury and necrosis
- Rationale
- possible early identification of patients with acute myocardial infarction for intervention (thrombolysis PTCA)
- the role of out-of-hospital 12-lead ECG is not universally available but is appropriate in most EMS settings with proper medical oversight
- Advantages/ disadvantages
- ST segment elevation
- height, depth and contour
- ST (acute changes)
- anterior wall -- significant ST elevation in V1- V4 may indicate anterior involvement
- inferior wall -- significant ST elevation in II, III and aVF may indicate inferior involvement
- ST segment depression in eight or more leads
- ST segment elevation in aVR and V1
- Q waves
- depth, duration and significance
- greater than 5 mm, greater than .04 seconds
- may indicate necrosis
- may indicate extensive transient ischemia
- depth, duration and significance
- Rationale
- ECG rhythm analysis
- Electrophysiology and wave forms
Content Creator: Bridget Kammerzelt
CAPCE Course Number: 20-EMTP-F3-7206
Total CE Hours: 1.5
Level: Advanced
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.