Training activity information
Details
Perform the following manoeuvres:
- Anterograde and retrograde curves
- Entrainment and measuring a post pacing interval
- Sense extra stimulus
- Assessing for a line of block
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee​.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What knowledge do you need about the techniques for performing anterograde and retrograde studies, entrainment, sense extra stimulus, and assessing for a line of block?
- What specific practical skills do you hope to develop in performing these essential EP study manoeuvres? What is your current theoretical understanding of these techniques, and how will this hands-on experience solidify your knowledge?
- Have you reviewed the protocols and techniques for performing each of these manoeuvres? What potential technical challenges might you encounter, and how will you seek guidance during the procedure? How do you feel about actively performing these manoeuvres, and what steps will you take to ensure you follow instructions precisely?
In action
- Focus on the technical execution of each manoeuvre. How are you adjusting the pacing parameters? Why are you performing each step in a specific sequence? What decisions are you making regarding the pacing rate, coupling intervals, and duration of stimulation? What aspects of performing these manoeuvres feel technically demanding, and what requires more precise manipulation of the pacing system?
- How effectively are you eliciting the desired electrophysiological responses with each manoeuvre? Are you able to accurately measure the post-pacing interval and assess for a line of block? What challenges are you facing in achieving consistent capture or accurately determining the refractory periods and conduction properties? What are you learning about the practical application of these diagnostic manoeuvres in understanding arrhythmia mechanisms? How does this activity build upon your knowledge of basic pacing principles and cardiac electrophysiology?
- Are you adjusting the pacing parameters based on the patient’s response and the observed electrophysiological findings? What support or guidance might you need from the supervising physician regarding the technical aspects of performing these manoeuvres or troubleshooting any difficulties encountered? Are you ensuring these manoeuvres are performed safely and under appropriate supervision?
On action
- What did you notice? Describe how you performed each of the listed manoeuvres during the EP study. What technical aspects did you focus on? What were the immediate observations following each manoeuvre?
- What did you learn from the activity? Reflect on the practical application of performing these key EP study manoeuvres. Did you improve your technical skills in manipulating catheters or delivering pacing stimuli? Did you gain a better understanding of the electrophysiological principles underlying each manoeuvre? Were there any challenges you encountered? How does this activity contribute to your procedural skills in electrophysiology?
- What will you take from the experience moving forward? Identify any specific manoeuvres where you need to refine your technique or deepen your understanding. How will you approach performing these manoeuvres in future EP studies? What opportunities for further practice or guidance will you seek?
Beyond action
- Have you revisited experiences of performing these EP manoeuvres? What technical skills did you develop in performing each manoeuvre accurately? Review similar experiences involving EP procedures and diagnostic manoeuvres. Discuss the technical nuances of performing these manoeuvres effectively with experienced EP physiologists.
- How have these experiences impacted upon your current practice? Recognise the practical skills required to elicit diagnostic information during EP studies. How has your hand-eye coordination and technical proficiency in manipulating EP catheters improved? How has this experience influenced your understanding of how these manoeuvres help to define the electrophysiological substrate? How will this learning support you in more complex EP procedures?
- How might these experiences contribute towards your future practice? Identify transferable skills such as technical dexterity, procedural awareness, and understanding of electrophysiological principles. How will you continue to refine your skills in performing these and other EP manoeuvres? How might you contribute to training programs for new EP staff?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 6 |
Outcome
Perform cardiac physiological role for simple electrophysiology procedures for diagnostic investigations and delivery of therapies to help terminate arrhythmias. |