Coursework

This virtual 100% online course will consist of students completing 4 separate modules, with each module consisting of lectures, hands-on sessions, tutorials and case studies covering the entire clinical and technical scope of cardiac electrophysiology. Each module and unit will be assessed by both online exams and a practical take home workbook.


Module 1:  Introduction to EP Concepts

Lectures Summary of Topics Covered
Cardiac Anatomy and Physiology
  • Cardiac anatomy
  • Cardiac physiology
  • Cardiac action potential
  • Sympathetic and parasympathetic nervous system
  • Cardiac conduction system
  • Plus much more…
Principles of Electrophysiology:
Part 1
  • Goals, indications, risks and complications of EPS
  • X-ray positions and terminology
  • EP recording, stimulation and ablation equipment and hardware
  • Arterial and venous access and approach
  • Basic catheter locations and navigation techniques
  • Retrograde aortic and transseptal approaches and techniques
  • ECG and EGM signals and nomenclature
  • Baseline intracardiac recording positions, intervals and measurements
  • Normal sequence of activation (antegrade and retrograde)
  • Plus much more…
Principles of Electrophysiology:
Part 2
  • Programmed stimulation nomenclature, threshold performance and variables
  • Effective (ERP), relative (RRP) and functional refractory periods (FRP)
  • Latency, pseudoblock, fusion and pseudofusion
  • Gap phenomena
  • Antegrade and retrograde refractory period definitions
  • Pacing protocols including programmed and sensed extra-stimulus, incremental and burst pacing
  • Antegrade and retrograde conduction sequence definitions
  • SNRT, CSNRT, SACT, CSM and VT stimulation protocols
  • Goals and predictive value of VT stimulation protocols
  • Plus much more… 
Bradyarrhythmias and Conduction System Dysfunction 
  • Syncope: demographics, clinical features, risk and progression;
  • EP evaluation of sinus node dysfunction
  • EP evaluation of AV node and His bundle dysfunction
  • Invasive and non-invasive diagnostic techniques
  • Plus much more…

Module 2:  Atrial Arrhythmias and Management

Lectures Topics Covered
Cardiac Pharmacology
  • Antiarrhythmic drug classification
  • Class Ia, Ib, Ic, II, III, IV, V
  • Pharmacodynamics
  • Pharmacokinetics
  • Clinical efficacy
  • Proarrhythmia
  • Toxicity and adverse effects
  • Plus much more…
Principles of Ablation
  • Ablation energy methods: radiofrequency, irrigated tip and cryoablation
  • Ablation equipment and electrical circuit
  • Determinants of lesion size and depth
  • Anatomy, histology and pathophysiology of lesion formation
  • Theory and principles of temperature and impedance monitoring
  • Thrombus formation and steam pop
  • Cryoadhesion, cryomapping and cryoablation
  • Plus much more…
Atrial Flutter
  • Types and mechanisms of isthmus and non-isthmus dependent atrial flutter
  • General characteristics, presentation, incidence and features of atrial flutter
  • Cavo-tricuspid isthmus
  • Entrainment mapping
  • Activation mapping, isthmus mapping and bi-directional block
  • Gaps in isthmus lesions
  • Ablation indications, complications, success, recurrence and methods for radiofrequency and cryothermal energy
  • Plus much more…
Atrial Fibrillation
  • Classification of AF (paroxysmal, persistent, permanent)
  • AF risk factors and mortality
  • Atrial pathology and electrical remodelling
  • AF mechanism theories
  • Therapy aims of AF (rate versus rhythm control) including anticoagulation
  • AF ablation techniques including Ablate and pace, Maze procedure, Pulmonary vein isolation, Circumferential pulmonary vein ablation, Pulmonary vein antrum ablation, Complex fractionated atrial electrograms and Autonomic denervation
  • Ablation success rates, complications and endpoints
  • Plus much more…

Module 3:  SVT and Tachycardia Mechanisms

Lectures Topics Covered
Mechanisms of Arrhythmias
  • Abnormal automaticity, triggered activity and reentry
  • Criteria for reentry
  • Early and delayed afterdepolarisations
  • Concealed conduction
  • Entrainment vs. Post Pacing Interval
  • Electrophysiological evaluation of supraventricular tachycardia
  • Procedure for SVT evaluation
  • Plus much more…
AV Node Reentrant Tachycardia
  • Dual AV node anatomy and physiology, including the Triangle of Koch
  • Upper and lower common pathways
  • Mechanism of dual AV node reentry tachycardia, (slow/fast, fast/slow and slow/slow)
  • Electrophysiologic characteristics of typical and atypical AV node reentry tachycardia
  • Differential diagnostic pacing manoeuvres
  • Radiofrequency and cryothermal ablation methods of dual AV node physiology
  • Positive predictive signs of ablation
  • Markers for immediate ablation cessation
  • Ablation indications, techniques and endpoints
  • Plus much more…
AV Reentrant Tachycardia
  • Anatomy of right vs. left sided bypass tracts
  • Concealed accessory pathways
  • Wolff-Parkinson-White and pre-excitation syndrome
  • Orthodromic and Antidromic AV reentry tachycardia
  • Provocative manoeuvres for bypass tract differentiation
  • Wolff-Parkinson-White syndrome and Sudden Cardiac Death
  • Location and frequency of accessory pathways
  • Antegrade and retrograde mapping techniques
  • Radiofrequency and cryothermal ablation indications, techniques and endpoints
  • Plus much more…
Atrial Tachycardia
  • Types and mechanisms of atrial tachycardias (focal vs. macroreentrant)
  • EP characteristics of atrial tachycardias including activation sequence
  • P wave morphology and ECG diagnostic techniques
  • Activation and pace mapping techniques
  • Ablation indications, success rates, complication rates, recurrence rates, techniques and endpoints
  • Plus much more…

Module 4:  VT and Rare SVT’s

Lectures Topics Covered
VT: Mechanisms, Mapping & Management
  • Sudden Cardiac Death: prevalence, presentation, risk factors, substrate and evaluation methods
  • Ventricular Arrhythmias mechanisms, characteristics and termination methods
  • VT mapping techniques (activation mapping, pace mapping, fractionated potentials, entrainment mapping, mid-diastolic potentials, Purkinje potentials, bundle branch mapping)
  • Focus localisation using ECG
  • VT Disease States, treatment and ablation:
    • MI related
    • Dilated cardiomyopathy
    • Right ventricular outflow tract
    • Left ventricular outflow tract
    • Verapamil sensitive fascicular
    • Bundle branch reentry
  • Plus much more… 
VT: Inherited Arrhythmias
  • Arrhythmogenic right ventricular cardiomyopathy
  • Hypertrophic cardiomyopathy
  • Long QT syndrome
  • Catecholaminergic Polymorphic VT
  • Brugada Syndrome
  • Plus much more…
Rare Supraventricular Tachycardia Syndromes
  • Atriofascicular fibres and Mahaim Tachycardia; Fasciculoventricular fibres; Persistent junctional reciprocating tachycardia:
    • general characteristics
    • electrocardiographic features
    • electrophysiological characteristics
    • treatment
    • ablation methods
    • mapping techniques
    • success rates and endpoints.
    • Plus much more…

Hands-On Sessions

Each module will be accompanied by stimulating hands-on sessions allowing practical exposure to relevant topics. Hands on sessions include:

  • Cardiac anatomical dissection
  • EP equipment hardware
  • Catheters and sheaths
  • Wet lab ablation

Pre-recorded Live Ablations

  • Pre-recorded live ablations from multiple SVT and VT procedures will be available for on-demand viewing.  These will include AV Node Reentry Tachycardia (AVNRT), AV Reentry Tachycardia (AVRT), Atrial Tachycardia (AT), Atrial Flutter (AFL), Atrial Fibrillation (PVI) and Ventricular Tachycardia (VT) using radiofrequency and/or cryothermal energy.  The EP physician will present a detailed case history of the patient prior to each procedure, and will provide live commentary during each procedure.  You will be able to see all EGM/ECG signals, x-ray fluoroscopy and 3D electroanatomic mapping images the team performing the ablation see
  • These are an invaluable and unique tool to allow students to actually see the application of concepts being used in real world clinical practice
  • These are planned to be available ASAP but COVID has made performing and recording these extremely difficult, so bear with us while we work towards these

Case Studies and Tutorials

Case studies and tutorials are an integral part of the course, and are designed to place the theoretical concepts taught in each module into real-life clinical scenarios.

Case studies will include:

  • Basic Diagnostic EPS
  • Sinus Node Dysfunction
  • AV Node-His Purkinje Dysfunction
  • AVNRT
  • AVRT
  • PJRT
  • Fasciculoventricular Fibre
  • AT
  • AFL
  • RVOT VT
  • Brugada Syndrome

Tutorials will include:

  • X-ray orientation
  • RF ablation graph interpretation
  • How to perform a HRVPB protocol
  • How to perform a Para-Hisian Pacing protocol

Video Tutorials will include:

  • How to load and prime an irrigated catheter infusion pump
  • EP catheters
  • EP connector cables
  • EP short sheaths
  • EP long sheaths

Personal One-On-One Tutorials

EP can be complex and difficult to understand, which is why all enrolled students are able to book personal one-on-one online tutorial with a qualified EP physiologist to facilitate learning, discuss course content, assessments or workbooks, or anything else that needs clarifying.  It’s this personal approach we feel sets us apart from other training organisations.

Screen sharing is enabled to help with any discussions or clarification of EGMs, however video footage of the student can be disabled at your request so as to maintain privacy


Live-Streamed Workshops

  • Students will also have full access to monthly 60-90 minute scheduled live-streamed workshop sessions
  • The sessions will deliver case studies, tutorials or general Q & A
  • Students will have the ability for live interaction and discussions
  • The sessions will be scheduled at various days and times to allow participants many options to attend 
  • The sessions are invaluable in allowing interaction with peers and to clarify unfamiliar or complex concepts

As CEPIA is a registered training organisation (RTO), the course consists of nine (9) units of competency. Embedded in the required knowledge for the units of competency is a significant body of high level underpinning knowledge related to cardiac anatomy and physiology; cardiac pharmacology; principles of ablation; and mechanisms of arrhythmias. Participants must demonstrate competence in all nine (9) units to gain the qualification. A Statement of Attainment will be issued for any unit of competency satisfactorily completed if the full qualification is not completed.


 Code  Unit Title
 CEPPRE001  Apply the principles of electrophysiology (EP) to diagnostic procedures
 CEPBCS002  Define and diagnose bradyarrhythmias and conduction system dysfunction
 CEPTAC003  Define, diagnose and treat AV Node re-entrant tachycardia
 CEPTAC004  Define, diagnose and treat AV re-entrant tachycardia
 CEPTAC005  Define, diagnose and treat rare supraventricular tachycardia syndromes
 CEPTAC006  Define, diagnose and treat atrial tachycardia
 CEPAFL007  Define, diagnose and treat atrial flutter
 CEPAFI008  Define, diagnose and treat atrial fibrillation
 CEPVTC009  Define, diagnose and treat ventricular tachyarrhythmias

 

 

 

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