Presentations
- Atypical chest pain
- Bradycardia
- Cardiovascular collapse, including resuscitated cardiac arrest
- Drug overdose
- Family history of sudden cardiac death
- Fetal hydrops
- Irregular pulse
- Palpitations
- Syncope
- Tachycardia
Conditions
- Bradyarrhythmia:
- Channelopathies (e.g. Brugada syndrome, CPVT, long QT syndrome)
- Ectopic beats:
- Fetal arrhythmia
- Rhythm disturbances secondary to electrolyte abnormalities
- Tachyarrhythmias:
- broad complex tachycardia (e.g. ventricular tachycardia [VT])
- narrow complex tachycardia (e.g. supraventricular tachycardia [SVT], including AVRT)
- Wolff-Parkinson-White syndrome
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Atypical chest pain
- Bradycardia
- Cardiovascular collapse, including resuscitated cardiac arrest
- Drug overdose
- Family history of sudden cardiac death
- Fetal hydrops
- Irregular pulse
- Palpitations
- Syncope
- Tachycardia
Conditions
- Atrial fibrillation
- Broad complex tachycardia (AVNRT, atrial flutter)
- Drug toxicity
- Refractory arrhythmias in acutely unwell patients
- Rhythm disturbances post-cardiac surgery
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Mechanisms of arrhythmogenesis
- Methods of presentation and clinical features of arrhythmias from fetal to adolescents
- Normal electrophysiology of the heart
- Pathogenesis, natural history, and prognosis of arrhythmias
- Types of structural heart disease and types of cardiac surgery associated with abnormal cardiac rhythm, including long-term effects that may manifest in adulthood
Investigations
- Appropriate use of invasive and non-invasive cardiac event recorders
- Exercise stress testing
- Interpretation of 12-lead ECG findings, including how to interpret an ECG taken during an adenosine challenge
- Interpretation of 24-hour Holter monitoring, as well as event monitors and implantable devices
Procedures
- External cardioversion
- Indications for electrophysiological studies and the use of radiofrequency ablation in the management of arrhythmias
- Temporary or permanent pacemaker insertion
- Counselling of acute management prior to presenting (e.g. SVT)
- CPR training
- Genetic counselling
- Indications for temporary and permanent pacemakers, and implantable defibrillators and denervation procedures
- Pharmacology of drugs used in the treatment of arrhythmias
- Recommendations for external defibrillators
- How to provide appropriate counselling
- Recommendations about exercise and lifestyle limitations
- Risk factors/Recommendations for risk mitigation
