Basics of Electrocardiography (Medicine, 3 Course)
Basics of Electrocardiography (Medicine, 3 Course)
«APPROVED»
Vice-Rector of Higher Education Institution
for Science and Education
_____________________Arkadii SHULHAI
«_____» _______________________ 2022
ACADEMIC PROGRAM
Approved by the Cyclic Subject Methodical Commission on Therapeutic Disciplines of Medical Faculty
on «___» __________ 2022, Minutes № ___
1. Description of the discipline
Elective course
Year of study
Branch of knowledge:
3rd
22”Health Care”
Semester
Duration of study – full term
5th 5th
Specialty: Lectures
Number of credits – 3 222 “Medicine”
Practical classes
Degree of higher 10 hours 10 hours
Total hours – 90 education: Student’s independent work
Second (Master) degree 35 hours 35 hours
Type of assessment
Differentiated credit
2. COMPETENCES AND PROGRAM LEARNING OUTCOMES
According to the Training Program "General Medicine" of the Second (Master) degree, specialty
222 "Medicine", branch of knowledge 22 "Health care", the course "Basics of
Electrocardiography" ensures the acquisition of the following competences and program learning
outcomes by students:
When studying the course “Basics of Electrocardiography” the following teaching methods
are used: verbal (story, conversation, explanation); practical (exercise, experiment, performance
task); explanatory and illustrative (lectures, educational literature, natural objects, videos, etc.);
inductive; deductive; analytical; traductive; reproductive; problem statement; heuristic; research;
The use of interactive technologies of joint and group learning (general circle, microphone,
brainstorming, case-method, etc.) promotes understanding of learning material; situational modeling
technologies (simulation or imitation); technologies for processing argued issues (defining a
viewpoint, defending it, changing a viewpoint, debates, talk shows, etc.); elements of distance
learning (MS Teams, Google Meet services, etc.).
As a result of studying the course "Basics of Electrocardiography" the student must know:
● the structure of the electrocardiograph and ECG recording technique;
● physiological and biophysical bases of electrocardiography;
● specific changes in the electrocardiogram in various pathological conditions;
● electrocardiological changes in acute cardiac disorders.
As a result of studying the course "Basics of Electrocardiography" the student must be able
to:
● register an ECG in 12 leads;
● identify elements of a normal ECG (vawes, segments, intervals);
● analyze the ECG: determine the pacemaker, reguliarity of heart rhythm, heart rate,
voltage of the ECG vawes, the position of heart electrical axis, measure the duration
and amplitude of ECG vawes, intervals, segments, cardiac cycle;
● interpret correctly the results of the identified changes.
4. CONTENT OF THE COURSE
Topic 1. Anatomy and clinical electrophysiology of the heart. Biophysical bases of formation
of an electrocardiogram.
Topic. Method of electrocardiogram registration.
Electrocardiographic leads: standard, amplified from the extremities, chest leads, additional.
Topic 3. Electrical axis of the heart.
Six-axis coordinate system (according to Bayley). Methods for determining the electrical axis of the
heart. Variants of normal ECG.
Topic 4. ECG recording technique.
Conditions of ECG - research, application of electrodes, attachment of wires to electrodes,
selection of amplification of the electrocardiograph, recording an electrocardiogram. Formation of a
normal ECG. Atrial depolarization (P-wave), P-Q (R) segment, ventricular depolarization, S-T
segment, ventricular repolarization, ventricular systole (Q-T interval)
Topic 5. Analysis of normal ECG.
ECG analysis: general scheme (plan) of ECG decoding. Визначення водія ритму, ознаки
нормального синусового ритму. Частота серцевих скорочень. Визначення вольтажу.
Визначення електричної осі серця. The main elements of the ECG: diagnostic meaning of the
duration and amplitude of waves, the duration of the intervals and segments. The ECG conclusion.
Topic 6. Hypertrophy of heart chambers.
ECG signs of left and right atrial hypertrophy. Signs of hypertrophy of both atria. ECG signs
of left and right ventricular hypertrophy. Signs of hypertrophy of both ventricles.
Topic 7. Violation of the function of automatism.
ECG signs of sinus tachycardia, sinus bradycardia, sinus arrhythmia. Sick sinus syndrome,
sinus arrest.
Topic 8. Active ectopic complexes and rhythms.
Extrasystole: classification, ECG signs of supraventricular (atrial, atrioventricular) and
ventricular extrasystoles. Paroxysmal tachycardia: classification, ECG signs of supraventricular
(atrial, atrioventricular) and ventricular paroxysmal tachycardias.
Topic 9. Atrial and ventricular flutter and fibrillation.
Classification, ECG signs.
Topic 10. Impaired conduction of the heart.
Classification. ECG signs of premature ventricular excitation (Wolf-Parkinson-White
syndrome). ECG signs of sinoatrial, atrial, AV block. The concept of Morgagni-Adams-Stokes
syndrome and Frederick syndrome.
Topic 11. Impaired intraventricular conduction of the heart.
ECG signs of intraventricular block: unifascicular, bifascicular and threefascicular.
Topic 12. ECG diagnosis in chronic forms of coronary heart disease.
ECG signs in chronic forms of coronary heart disease: angina pectoris, cardiosclerosis, silent
ischemia. Functional tests: types and diagnostic ECG criteria. The concept of Holter ECG
monitoring.
Topic 13. ECG diagnosis in myocardial infarction
ECG signs of myocardial infarction: STEMI and non-STEMI (Q myocardial infarction and
non-Q myocardial infarction). ECG stages of myocardial infarction, its topical diagnosis, reciprocal
changes.
Topic 14. ECG in some pathological conditions.
ECG signs of myocarditis, pericarditis, cardiomyopathy, electrolyte disbalance, intoxication with
cardiac glycosides, pulmonary embolism. ECG in patients with an artificial pacemaker.
5. STRUCTURE OF THE COURSE
TOPICS OF LECTURES
This course does not include lectures
.
THEMATIC PLAN OF STUDENT’S INDEPENDENT WORK
The knowledge in the course is assessed by current and final performance. The maximum points a
student receives for the course is 200 points.
The grade for the training session is positive if it is 4.0 points or more.
Сurrent performance is calculated at the end of studying a discipline taking into account the average
grade in training sessions/seminars (rounding of the GRADE is carried out according to the scheme:
the range from 0 to 0,24 is rounded to a smaller unit; the range from 0.25 to 0.74 is rounded to 0.5;
the range from 0.75 to 0.99 is rounded to a larger unit). Subsequently, the average performance
garde is converted into a 200-point assessment scale.
Average grade Scores on a 200-point assessment scale
4 66
4,5 69
5 72
5,5 75
6 78
6,5 81
7 84
7,5 87
8 90
8,5 93
9 96
9,5 99
10 102
10,5 105
11 108
11,5 111
12 114
The maximum points a student can score for current academic performance is 120 points
(114 points for formative assessment and another 6 points for students’ individual work).
ASSESSMENT OF FINAL PERFORMANCE
Performance at the end of studying the parts of a course is assessed in the form of a credit.
The maximum points a student receives for a credit is 200 points (194 points for academic
performance and 6 points for individual work).
The score obtained by a student in the discipline is converted according to the scale of the
European Credit Transfer System (ECTS).
The students are admitted to take a credit test if they have no academic debt; have
minimum points for academic performance (4.0); completed all types of work according to the
academic program on the discipline.
9. MEANS FOR FORMATIVE AND SUMMATIVE ASSESSMENT
1. Test tasks
2. Case problems.
3. Recorded electrocardiograms.
9. REFERENCES
Basic:
1. Romeo J Vecht. ECG Diagnosis Made Easy..Informa Healthcare; 9th Edition. – 2019.- 207
pp.
1. Ashcheulova Т. V. Electrocardiographic examination of patients with conductivity function
alterations : mеthodical instruction for students / Т. V. Ashcheulova, O. N. Kovalyova, A. V.
Demydenko ; Kharkiv National Medical University. – Kharkiv: KhNMU, 2017. – 16 p.
2. Electrocardiographic method of cardiac function examination. Technique of ECG
registration and reading : methodical instructions for students / Т. V. Ashcheulova, O. N.
Kovalyova, A. V. Demydenko. – Kharkiv : KhNMU, 2017. – 25 p.
3. Ashcheulova Т. V. Electrocardiographic examination of patients with automaticity and
excitability function alterations : mеthodical instruction for students / Т. V. Ashcheulova, O.
N. Kovalyova, A. V. Demydenko ; Kharkiv National Medical University. – Kharkiv :
KhNMU, 2017. – 27 p.
4. ECG signs of hypertrophy of heart atriums and ventricles : methodical instructions for
students / Т. V. Ashcheulova, O. N. Kovalyova, A. V. Demydenko. – Kharkiv : KhNMU,
2017. – 15 p.
5. Ashcheulova Т. V. The main ECG syndromes of the myocardium damage (ischemia, injury,
necrosis). ECG in myocardial infarction : mеthodical instruction for students / Т. V.
Ashcheulova, O. N. Kovalyova, A. V. Demydenko ; Kharkiv National Medical University. –
Kharkiv : KhNMU, 2017. – 12 p.
2. Propedeutics of internal diseases. - Vinnytsya : Nova knyha publ., 4th edition .P. 1 :
Diagnostics / O. N. Kovalyova, T. V.Ashcheulova. - 2nd ed. - 2020. - 424 pp.
3. Kaplan Qbank and USMLE World.
Additional:
1. Malcolm Thaler. The Only EKG Book You'll Ever Need.б 9 th edition– 2019. – 260 pp.
2. Centhia Webner, Karen Marzlin. Advanced 12 leads ECG interpretation, 2016. – P.2-30.
3. J. Huff. ECG Workout: Exercises in Arrhythmia Interpretation (Huff, ECG
Workout) 7th Edition Publisher : Lippincott Williams & Wilkins. – 2016. · 378 pp.
4. D. Anderson, medical Creations, M. Mastenbjork, S. Meloni. EKG/ECG Interpretation:
Everything you Need to Know about the 12-Lead ECG/EKG Interpretation and How to
Diagnose and Treat Arrhythmias. – Independently Published, 2016. — 217 p.
Web resources:
1. https://www.tdmu.edu.ua/
2. https://library.tdmu.edu.ua/
3. http://www.webcardio.org/
4. https://www.escardio.org/
5. http://www.international.heart.org
6. https://moodle.tdmu.edu.ua/login/index.php
7. https://guidelines.moz.gov.ua/
8. https://www.youtube.com/channel/UCPHpx55tgrbm8FrYYCflAHw
9. https://www.youtube.com/c/osmosis
10. https://www.youtube.com/user/MEDCRAMvideos
11. https://www.lecturio.com/medical/
12. https://pubmed.ncbi.nlm.nih.gov/