HLTH6184 Cardiac Rhythm Management 1
This is a specialist Healthcare Science module. It will enable you to progress your healthcare science knowledge from practitioner to an advanced practitioner level developing knowledge in history taking, physical examination through to selecting appropriate cardiac investigations, analysing clinical findings and diagnostic decision-making in cardiac rhythm management.
Aims and Objectives
The aim of this module is to develop your knowledge and skills in Cardiac Rhythm Management (CRM) to a level appropriate to an advanced practitioner.
Having successfully completed this module you will be able to:
- Demonstrate a comprehensive understanding of the anatomy and electrophysiology of the heart & its conduction system
- Critically understand the electrophysiology & haemodynamics of cardiac function
- Demonstrate an in-depth knowledge of the pathological conditions which require rhythm management
- Critically evaluate the pharmacological aspects of cardiac pacing
- Debate the significance of implant device technology & design
- Critically understand the clinical concepts of device implantation, & complications
- Provide a clinical rationale for pacing implant indications (including single, dual and CRT-P)
- Discuss the procedures, relevance & importance of follow up to optimise implanted devices
- Critically understand the regulations surrounding driving, clinical trials and the ethical aspects of device implantation
This module will focus more specifically on variants from the normal (the pathophysiological) and explore concepts of referral, diagnosis and prognosis. Through a variety of learning methods, it will bring students into contact with active clinicians and with researchers who are engaged in evaluating diagnostic tools and responsible for providing diagnostic services. The module is based on the hypothesis that both a quantitative and a qualitative understanding of clinical reasoning, improves clinical decision and makes for a better diagnostician within cardiac rhythm management. Syllabus: • Anatomy & Physiology: Structure and function of the heart and great vessels, components of the conducting system • Electrophysiology & haemodynamics: cardiac action potentials, autorhythmicity, cardiac cycle, control & role of autonomic system, cardiac output, A-V synchrony • Pathology: sinus node disorders, tachy/brady syndrome, chronotropic incompetence, carotid sinus syndrome, conduction system disorders, cardiac arrhythmias, cardiomyopathy, sudden cardiac death, heart failure • Pharmacology: The effect of anti-arrhythmic drugs on implanted pacemakers, Heart failure drugs, anaesthetic drugs used at implant • Device design and technology: Types of device, sensors, pacing lead characteristics and function, circuit requirements, power sources, programmable functions, modes, telemetry, energy calculations, impedances, energy delivery, threshold measurement and significance, battery longevity, units of measurement • Indications and modes: indications related to pacing mode, pacing codes, pre-implant assessment, pacemaker prescription, device selection, temporary pacing • Implant technique and complications: Environmental requirements & considerations, equipment required, implant procedures & techniques, measurements & checks taken at implant & their significance, normal acceptable values for measurements, documentation requirements, antibiotic requirements, early and late complications and their significance, • Follow-up: Equipment & personnel, clinic design, databases & patient records, counselling, patient support material, emergency equipment, timing cycles, trouble-shooting, optimal programming. • Recognise and describe the principles of specific pacing algorithms. • Describe the principles of arrange of rhythm management devices. • Describe the identifying feature of a chest x-ray with respect to pacing. • Paediatric considerations: indications, implant procedures, the effect of growth, counselling, complications • Associated regulations: DVLA regulations regarding driving, the conduct of clinical trials, ethical aspects of device implantation
It is intended this module will be accredited by the National School of Healthcare Science (NSHCS).
Learning and Teaching
Teaching and learning methods
• On line materials for physiological science preparation • Lectures on key themes • Study groups • Blackboard and other on-line materials • Case based clinical scenarios using laboratory results • Clinical mentors in students’ work base • Problem solving workshops designing clinical tools • Facilitated discussion online/Professional conversations delivered in the classroom • Locating and using web based resources • Networking with other students via e-mail/discussion board • Work based activities • Literature retrieval and analysis • Guided reading
|Wider reading or practice||140|
|Total study time||250|
Resources & Reading list
Bickley, L. (2012). Bates Guide to Physical Examination and History Taking.
Hayes, D et al (2013). Cardiac Pacing, Defibrillation and Resynchronisation.
Brown, Hilary, (1997). Physiology and Pharmacology of the Heart..
Brauwald, E. (2014). A Textbook of Heart Disease 10th Edition.
Ellenbogen, KA et al (2008). Cardiac Pacing and ICDs.
Kumar,P. and Clark,M. (2012). Clinical Medicine.
Barold, S et al (2010). Cardiac Pacemakers and Resynchronisation. Step by step.
Connelly, D et al (2006). Implantable Cardiac Pacemakers and Defibrillators: all you wanted to know.
Dains,J., Ciofu L , Scheibel,P. (2011). Advanced Health Assessment and Clinical Diagnosis in Primary Care.
Llewelyn, H., Ang,H., Lewis,K. and Al-Abdullah,A. (2009). Oxford Handbook of Clinical Diagnosis.
Katz, D. (2001). Clinical Epidemiology and Evidence Based Medicine. Fundamental principles of clinical reasoning and research.
Presentation (Case study)
|Written essay (3500 words)||100%|
Costs associated with this module
Students are responsible for meeting the cost of essential textbooks, and of producing such essays, assignments, laboratory reports and dissertations as are required to fulfil the academic requirements for each programme of study.
In addition to this, students registered for this module typically also have to pay for:
Printing and Photocopying Costs
Students have access to the library but may wish to purchase their own texts. There will be additional costs for printing journal articles should the student require a printed version
Please also ensure you read the section on additional costs in the University’s Fees, Charges and Expenses Regulations in the University Calendar available at www.calendar.soton.ac.uk.