Title Heart Rhythm Management Pacing Management
Type Stage One
Code HPS108
Requirement Compulsory

Module objective

By the end of this module the Clinical Scientist in HSST, with respect to heart rhythm management and pacing, will be able to critically analyse, synthesise, evaluate and apply knowledge with respect to the fundamentals of cardiac stimulation, the equipment used for cardiac pacing, guidelines and troubleshooting. They will be expected to perform a range of clinical skills in adults and/or paediatric patients as appropriate to the clinical role and consistently demonstrate the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist within a patient- focused service.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will critically analyse, synthesise, evaluate and apply their expert knowledge of heart rhythm in adult and/or paediatric patients, including:

  • the anatomy of the conduction system and the propagation of impulses throughout the heart;
  • techniques, modalities, indications, interpretation and the diagnostic yield of non-invasive monitoring techniques such as conventional 12-lead ECG, Holter and event monitoring, implantable loop recorders;
  • causes and prevention of stroke;
  • assessment of stroke risk (scoring systems) and anticoagulant therapy and application to the pacemaker population;
  • relevant physics laws, measurements and units;
  • the causes of syncope and pre-syncope;
  • the influence of drugs on bradyarrhythmias;
  • the anatomy of the main components of the peripheral venous system commonly used for vascular access during pacemaker implantation;
  • the indications and international and national guidelines for correct pacemaker prescription, including pacing mode selection;
  • detrimental effects of right ventricular pacing;
  • recognition of lead problems and programming issues specifically related to leads;
  • the principles of programming pacemakers to maximise therapeutic benefit and minimise complications;
  • the principles of the management of ICD malfunction and troubleshooting;
  • the fundamentals of cardiac stimulation;
  • pulse generator and pacemaker lead characteristics;
  • published guidelines for implantation and device/mode selection;
  • principles of pacemaker programming to maximise clinical benefit and minimise complications;detrimental effects of right ventricular pacing;
  • pacemaker malfunction and troubleshooting.

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will be able to demonstrate a critical understanding of current research and its application to the performance, adaptation and mastery of a range of clinical and communication skills in adult and/or paediatric patients and will:

  • clinically evaluate (history, physical exam) patients with rhythm disorders;
  • assess heart failure status and stroke risk;
  • integrate the results from different diagnostic techniques into the individual care of patients;
  • interpret and assess electrograms, markers, intervals, Holter features, and other storage and diagnosis capabilities;
  • implement appropriate programming and/or medical intervention in response to new findings;
  • evaluate device diagnostic data in the clinical context and in reference to other non-invasive or invasive techniques;
  • reflect on the challenges of applying research to practice in relation to the diagnosis and management of patients requiring pacemaker implantation,building on a critique of available evidence.

Attitudes and behaviours

By the end of this module the Clinical Scientist in HSST will be expected to critically evaluate their own response to both normal and complex situations, consistently demonstrating the professional attributes and insights required of a Clinical Scientist in HSST working within the limits of professional competence, referring as appropriate to senior staff, and will:

  • educate patients about the treatment options available to them and explain the treatment strategies;
  • work closely with other healthcare professionals as necessary: cardiologists, infection control, care of the elderly, etc.;
  • appreciate the psychological impact of the patient’s arrhythmia illness on the patient and their family, and manage it sensitively;
  • recognise and remain up to date with developments in the field.


Code Title Action
HPS1-1-1-20 Cardiac (Adult) [v1] View
HPS1-1-2-20 Cardiac (Congenital and Paediatric) [v1] View
HPS1-1-3-20 Cardiac (Adult Congenital) [v1] View