Advanced ECG Interpretation Boot Camp

In 2011, I established Medicus of Houston, a provider of continuing education for physicians and other medical personnel specializing in advanced ECG interpretation and dysrhythmia analysis.

Over the last 30 years, I became aware that most non-cardiologist physicians read 12-lead ECGs at a very rudimentary level. The Advanced ECG Interpretation Boot Camp was designed to raise the bar for 12-lead ECG interpretation. The Boot Camp has been held biannually since 2012, but will take place on four occasions in 2015. The first two classes have been scheduled for March 10-13 and June 23-26. There will be late summer and late fall classes as well, to be announced later. All classes are held in the Medicus of Houston teaching facility, located in the Galleria-Post Oak area of Houston. A number of hotels are either next door or across the street from the facility.

The Advanced ECG Interpretation Boot Camp addresses an area of ECG education that is quite lacking in North America: advanced ECG analysis and interpretation. While there are literally hundreds of introductory ECG courses available as live courses or online, there is very little opportunity for more advanced education. 

Each boot camp lasts four full days, from 8 am until 5 pm. Teaching methods include didactic instruction, multimedia presentations, and animations. Included in each Boot Camp is up to 14 hours of active participation in the interpretation of complex ECGs — guided by either Michael Davis, MD, FACC or myself. The live class gives us the chance to teach not just the technical aspects of electrocardiography, but also the art of ECG interpretation. Interpreting a 12-lead ECG demands judgment and decisions based on that judgment — not just recording a number or a point on a graph. This elevates it to an art. The art of ECG interpretation is not being taught today.

The Advanced ECG Interpretation Boot Camp begins with an overview of the action potential — both nodal and non-nodal. We all learn about action potentials, but never really understand how they relate to what you see on an ECG. When you are interpreting at an advanced level, you need a lot more familiarity than that. Each participant becomes very familiar with the hexaxial reference grid and how it relates to the anatomy of the thorax. Blocks and AV dissociation are introduced in depth and chamber enlargements are studied closely, especially with regard to their propensity to create false infarction patterns.

At the beginning of the atrial dysrhythmia section, attendees are introduced to laddergrams, used to analyze complex dysrhythmias. This is the only live course that teaches laddergrams in depth (other than the Advanced Dysrhythmia course, below). Wide complex tachycardias are studied extensively, so each participant develops more confidence in diagnosing them. Pacemakers also receive in-depth attention. Each participant receives a separate workbook for laddergrams, wide complex tachycardias, and pacemakers.

Advanced Dysrhythmia Course

The Advanced Dysrhythmia Course was developed to complement the Advanced ECG Interpretation Boot Camp. It is a much deeper look at complex dysrhythmias. At Medicus of Houston, complex dysrhythmias are defined as those dysrhythmias that are a result of two or more spontaneous irregularities in the heart rhythm. They are usually caused by simultaneous ectopic pacemaker discharges combined with various SA, AV, or exit blocks. They generally exclude those dysrhythmias with a name, such as atrial fibrillation or ventricular tachycardia. However, advanced aspects of the classic, “named” dysrhythmias are also addressed during the course.

The Advanced Dysrhythmia course lasts three days and, like the Advanced ECG Interpretation Boot Camp, will take place in the Medicus of Houston teaching facility. It is scheduled for July 22-24, 2015.

The course begins with a detailed study of laddergrams, since they will be used throughout the course. That is followed by an introduction to the concept of the conductible interval and AV dissociation. Reading actual 12-lead ECGs and rhythm strips by each participant begins almost immediately — all done in class with our instructor providing support and direction.

Other topics include concealed conduction and concealed transseptal conduction, AV nodal behavior (Parts I and II), ventricular ectopy, aberration, narrow and wide complex tachycardias, and SA nodal behavior. The course is rounded out by up to 11 hours of active participation in the interpretation of complex dysrhythmias. 

Both classes are limited to just 10 participants. This allows more active participation, more individual attention, and the flexibility to revisit a concept that may require more explanation. Medicus of Houston is known worldwide, and the provenance of attendees has tended to be international. This sometimes causes the classes to fill early, and thus, close well before the scheduled registration cut-off date.

About the Instructors

Jerry W. Jones, MD is the principal instructor for both courses. He has been on the teaching faculties of the University of Oklahoma and the University of Texas Medical Branch in Galveston. Originally trained as a specialist in internal medicine, Dr. Jones entered the nascent specialty of emergency medicine during the 1970s, followed by board certification in Emergency Medicine. Electrocardiography has been of special interest to Dr. Jones for over 30 years, during which time he has become quite expert in the field. He began teaching electrocardiography in the early 1980s. He now divides his time between teaching electrocardiography and practicing telemedicine, for which he has been featured in the Annals of Emergency Medicine and The New York Times.

Michael Davis, MD, FACC is a cardiologist who is currently on the faculty of the University of Texas Health Science Center in Houston, where he is an adjunct clinical professor in the cardiology fellowship program. His teaching responsibilities include cardiac catheterization procedures, interventional cardiology, and cardiovascular hemodynamics. 

To learn more about both courses, visit the website at https://www.advancedecgcourse.com.