Palpitations, stroke and sudden death. Atrial fibrillation - a challenge to the clinician., 7.5 credits

The semesters 5 and basic electrocardiography knowledge of the physician programme. Good knowledge and an approved course parts in cardiovascular physiology.

The general aim is that the student, on completion of the course, should have a advanced knowledge and understanding of cardiovascular diseases .

The knowledge is tiered according to the SOLO taxonomy and the skills according to Miller's pyramid.

Knowledge and understanding:
Understand the anatomy of the heart and electrophysiology in several complex clinical contexts (S3). Understand arrhythmia mechanisms and the most common atrial tachycardias (S2). Understand triggering and maintenance mechanisms including advanced knowledge of several of the most common diseases of the cardiology (S3). Be able to treat atrial fibrillation, as well as basic diseases, risk factors and specific antiarrhythmic treatment of different types (S3). Know and understand underlying mechanisms of risk factors for embolism risk and be able to discuss the needs of thromboembolism prophylaxis (S3). Understand epidemiological relationships and application of statistics in clinical issues (S2). Be familiar with complications of treated non-treated atrial fibrillation (S2). Understand factors for different expressions of disease for the same arrhythmia types (S3). Be able to demonstrate an increased understanding of the application of pharmacological principles (S2).

Skills
Be capable of independent electrocardiography interpretation (M3). Be able to carry out cardioversion (M1)
Be able to conduct adequate reasoning around treatment options in clinical situations (M3). Be able to apply a scientific approach to clinical issues (M3).

Attitude
Be able to handle (M3) the weaknesses and limitations of medical and personal knowledge, identify and evaluate risks for the patient, himself/herself and others. Have developed a high level of professional approach through repeated discussions of clinical problems, including the relation to the patient's autonomy, co-determination rights and other ethical problems where the subject is particularly appropriate, as a number of very different treatment options are often available (M3).
The strong elements of scientific application have as their aim to contribute to the development of the student's degree of individual scientific maturity.

The course is an enhancement of the knowledge of cardiovascular diseases that are included in the core, as atrial fibrillation occurs as a part phenomenon in e. g. heart failure, consciousness disorder, hypertension, endocrine disorders including diabetes, valvular disease, coronary artery disease, arrhythmias, stroke and dementia.

Integrating assignments in the course:
Dizziness
Abnormal heart activity
Faint/collapse

The course is, to a very large extent, based on placement education as well as case and seminar discussions, with the aim of understanding complex relationships, therapeutic considerations and positions based on various clinical scenarios with concurrent training in a consciously professional approach. The course is also to a large extent built on the student's individual contributions in the form of different study assignments, an advanced assignment that is presented and discussed, debates and literature survey from the perspective of for example Evidence based medicine (EBM)

Integrated in the course are subparts with teachers in, inter alia, clinical physiology, pharmacology, statistics, neurology and thoracic surgery. Gender perspectives, patients' autonomy and participation in decision-making processes are included. The research front of the field is brought up.

The course will give training in electrocardiography analysis, carrying out an adequate literature search, article review, training in use of statistics in assessment of clinical contexts and arguments based on EBM.

A considerable part of the course consists of placement with component parts of electrical conversion, various types of electrocardiography analysis, echocardiography, exercise ECG tests, electrophysiologic studies and ablation, pacemaker surgery and pacemaker control.

Examination takes place through an assessment if the student has achieved the course goals through the student's active participation in the compulsory parts and presentation of individual and group assignments. In addition, a written final examination that is based on the learning outcomes and the pedagogical contents of the course.

As part of the examination, the student should be able to conduct clinical reasoning based on theoretical knowledge, which is examined through active participation in discussion of seminar cases.

Compulsory parts
Participation in cases and seminar discussions, completed individual study assignments including an advanced assignment that is presented and discussed. For clinical parts, attendance is compulsory.

Limited number of examinations or practical training sessions
clinical parts can, as a rule, only be repeated once.

The course has been cancelled.

Course evaluation takes place according to the guidelines that have been established by the board of education at Karolinska Institutet.