Academic journal article American Journal of Pharmaceutical Education

An Elective Course in Cardiovascular Electrophysiology for Pharmacy Learners

Academic journal article American Journal of Pharmaceutical Education

An Elective Course in Cardiovascular Electrophysiology for Pharmacy Learners

Article excerpt


Deaths resulting from cardiovascular diseases remain a concern in the health care field. Despite emergency medicine advances and guideline updates, sudden cardiac death from arrhythmia accounts for several thousand deaths per year. (1) The cause of arrhythmia is multi-factorial and can include myocardial ischemia, electrolyte disorders, cardiomyopathies, hypertrophy, several classes of drugs, and channelopathies. (2) Additionally, the diagnosis and pharmacotherapy of arrhythmia presents its own set of challenges to health care professionals. Further complicating the matter, most agents used in the treatment of arrhythmia can potentially cause arrhythmia. These agents have complex pharmacokinetic profiles, multiple drug-drug interactions, and potential adverse effects other than precipitating arrhythmias. These challenging factors highlight the role that a pharmacist can play in the management of arrhythmia.

An electrocardiogram (ECG) recording is a diagnostic tool used to assess the overall cardiac health of a patient. They are easy to perform, inexpensive, and provide valuable information regarding the electrophysiological functioning of the heart, and studies indicate the prognostic value of an ECG reading. (3) Patients with complicated disease conditions such as arrhythmias are often on multiple medications and need to be monitored continuously. Pharmacists play a key role in fine-tuning patient therapies through interpretation of diagnostic tests. The intention of this course was not only to familiarize learners with ECG interpretation, but to also educate them on mechanisms underlining electrophysiological changes that cause abnormal rhythms. Such a course design would provide a unique skill set for pharmacy learners, which would give them an advantage when actively involved in patient assessment, treatment, and care management.

The curriculum at Western New England University College of Pharmacy (WNECoP) introduces learners to ECG interpretation as part of the patient assessment course in the fall semester of the second year (P2). The pharmacology of anti-arrhythmic agents and pharmacotherapy of arrhythmia is taught in the P2 spring semester as part of the Integrated Pharmacy Care (IPC) Cardiovascular Care module. Although the module introduces learners to rate and rhythm abnormalities, learners receive limited exposure to the interpretation of ECGs and the underlying mechanisms causing arrhythmias. The elective course, Cardiovascular Electrophysiology: From Bench to Bedside, was developed for third-year (P3) students to complement their knowledge base regarding arrhythmias and diagnosis based on interpretation of ECGs.

The complex language of an ECG can be overwhelming and confusing. The backbone of an ECG recording combines principles of ion channel physiology and concepts of electrophysiology. The aim of the course was to highlight how dysfunctional electrophysiological functions at the molecular level are translated into changes on an ECG. The other aim was to familiarize learners with various types of arrhythmias, with specific emphasis on the interpretation of ECGs. The elective course was developed to include variety of teaching formats including modified "chalk-talk" lectures, learner presentations, and case-based discussions using 12-lead ECG recordings. Specifically, these instructional methods were intended to create an environment that promoted active learning and critical thinking and also helped learners develop problem-solving skills. Additionally, learners were given the opportunity to practice in a high-fidelity simulation (HFS) suite mimicking cardiovascular events such as ST-elevation myocardial infarction (STEMI), heart blocks, and drug-induced overdoses. The objective of this manuscript is to communicate the design of the elective course, the challenges facing the course, and its role in a professional pharmacy program.


Cardiovascular Electrophysiology: From Bench to Bedside was offered as a 3-credit elective course to P3 pharmacy learners during the fall semester. …

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