updated February 2017

A Systematic Approach to Pharmacotherapeutically Relevant ECG Findings

Facilitator: Dr.Peter Loewen, B.Sc(Pharm), ACPR, Pharm.D., FCSHP, R.Ph.

GOAL

Residents will have an APPROACH to interpreting 12-lead ECGs such that they can INDEPENDENTLY identify pharmacotherapeutically relevant findings to enhance drug related issue detection and drug monitoring.

This workshop forms the basis for residents to go out and practice these skills on their own. Like most things, only repetition will allow residents to use these skills in their own practice.

SESSION OBJECTIVES

Following the workshop and following personal reflection and practice, residents should:

  1. Explain each of the 6 steps of their approach to ECG interpretation
  2. Use the 6-step approach, identify pharmacotherapeutically relevant findings on a 12-lead ECG, including:
    • Identifying NSR vs. not
    • Identifying AF
    • Recognizing ventricular hypertrophy
    • Recognizing injury/ischemia/infarction and its anatomic location
    • Recognizing conduction delays (AV node, repolarization) and correlating them to drug therapy
    • Recognizing ECG patterns for hyperkalemia, prolonged QT, antiarrythmic drugs

REQUIRED PRIOR KNOWLEDGE & SKILLS

  1. Describe normal cardiac function (the cardiac cycle) from a HEMODYNAMIC and ELECTRICAL viewpoint:  YouTube video |  YouTube video
  2. Relationship between the cardiac cycle and ECG waves: P, Q, R, S, T:  YouTube video 
  3. Review and PRINT Loewen’s ECG Approach PLOP of the 6 steps to take notes on.
  4. PRINT this collection of ECGs we'll use to illustrate and practice the approach.

BRING PAPER COPIES OF THE ECG COLLECTION AND THE 1-PAGER TO THE SESSION. INTERPRETING ECGS IS A TACTICLE PROCESS NORMALLY DONE USING PAPER.

VALUABLE RESOURCES

 

Online

Primary Literature

 

 

Old-skool

  • Dubin D. Rapid Interpretation of EKG’s. 6th Ed. 2007. amazon.com
  • Dubin’s Rapid Interpretation of EKGs – the classic book, shared with you

iOS & Android Apps

There are dozens. Search the relevant App store.