Cardiac Conduction: General Principles

In this course, we explain important concepts in the ECG diagnosis of cardiac conduction abnormalities. The principles explained here will facilitate your learning in the area of tachyarrhythmia diagnosis

1.0 x AMA PRA Category 1 Credits™
Available on the Pro Plan

PLAY INTRODUCTION

Overview

In this course, we define the key term ‘aberrant conduction’. We teach you how to identify the likely site of origin, within the heart, of escape rhythms and ectopic beats. We teach you how to recognize normal cardiac conduction on the ECG. We teach you the anatomy of the arterial blood supply of the cardiac conducting system. A knowledge of this vascular anatomy is necessary to understand important ECG abnormalities in ischemic heart disease. The principles and definitions explained here will facilitate your learning in the area of tachyarrhythmia diagnosis.

Faculty

Planner and Author: Dr John Seery MB PhD

  • Consultant Physician at St. Vincent's University Hospital, Dublin, Ireland
  • Lecturer at the School of Medicine and Medical Science, University College Dublin, Ireland
  • Studied medicine at the University of Cambridge, United Kingdom
  • A Natural Sciences graduate of Trinity College Dublin, Ireland
  • PhD in Cell Biology from University College London, United Kingdom


Planner: Dr Karen Strahan PhD (University of Cambridge), Head of Editorial
Planner: Tommy O'Sullivan, CME Manager
 

Estimated Time to Complete

1.0 hours

Target Audience

  • Physicians
  • Nurses
  • Nurse Practitioners
  • Physician Assistants
  • Paramedics

Learning Objectives

Upon successful completion of this activity, you will be able to:

  • Explain the concept of latent pacemakers
  • Identify aberrant conduction on the ECG
  • Determine the likely site of origin of an escape rhythm
  • Distinguish between atrial and ventricular premature contractions 
  • Distinguish between ectopic beats and escape beats on the ECG

Course Content

  • Introduction
  • The Frontal Schematic
  • Normal Cardiac Automaticity
  • Normal Conduction and the QRS Duration
  • Aberrant Conduction
  • Latent Pacemakers and Escape Rhythms
  • Fusion Complexes on the ECG
  • Ectopic Beats
  • Ectopic Beats - Pauses
  • Normal Cardiac Conduction on the ECG
  • Blood supply of the Cardiac Conducting System
  • Quiz

Release date

30-JUL-2020

Expiration date

29-JUL-2023

Instructions for Participation

Participants must complete the online activity during the valid period as noted above.
Follow these steps:

  1. View videos in sequence
  2. Complete quiz
  3. Complete the activity evaluation form to provide feedback for continuing education purposes and for the development of future activities
  4. Download the Certificate of Completion

Relevant Financial Disclosures

Planners and faculty for this activity have no relevant financial relationships with commercial interests to disclose.

Bibliography

Garcia T and Miller G. (2004) Arrhythmia Recognition: The Art of Interpretation. 1st Edition, Jones & Bartlett Learning.

Mangoni ME and Nargeot J. Genesis and regulation of heart automaticity. Physiol Rev. 2008;88(3):919-82.
https://journals.physiology.org/doi/pdf/10.1152/physrev.00018.2007

Futami C et al. The arterial blood supply of the conducting system in normal human hearts. Surg Radiol Anat. 2003;25:42-9.
https://link.springer.com/content/pdf/10.1007/s00276-002-0085-7.pdf

Williams PL. (1980) Gray’s Anatomy. Williams PL and Warwick R, Eds. Angiology (the coronary arteries) 669-73. 36th Edition, Churchill Livingstone, Edinburgh.

Suyama AC et al. Differentiation between aberrant ventricular conduction and ventricular ectopy in atrial fibrillation using RR Interval scattergram. Circulation. 1993;88(1):2307-14.
https://www.ahajournals.org/doi/pdf/10.1161/01.CIR.88.5.2307

Titus JL. Symposium, Cardiac arrhythmias (Part 1). Anatomy of the conduction system. Circulation. 1973;47(1):170-77.
https://www.ahajournals.org/doi/pdf/10.1161/01.CIR.47.1.170

Additional Reading

Yang YC et al. A Case of Complete Heart Block with Diagnostic Challenge and Therapeutic Dilemma. J Investig Med High Impact Case Rep. 2018;6: 2324709618788110.
 doi: 10.1177/2324709618788110.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6048603/pdf/10.1177_2324709618788110.pdf

Jakkoju A et al. Accelerated idioventricular rhythm. Proc (Bayl Univ Med Cent) 2018;31(4):506-7.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499534/pdf/ubmc-31-04-1493323.pdf

ACCME Accreditation Statement

Acadoodle, Ltd is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement

AMA Physician’s Recognition Award

Acadoodle, Ltd designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 
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