Harvard Medical School, Department of Continuing Education

ABCs of ECGs: Back to Basics for Frontline Clinicians

December 4, 2010 • The Hotel Commonwealth
Boston, Massachusetts

Course Directors:
Ary L. Goldberger, MD and Alexei Shvilkin, MD
Offered By: Beth Israel Deaconess Medical Center, Department of Medicine


Dear Colleague,

As a frontline practitioner, you face many ECG-reading issues that directly impact your patients' care on a day-to-day basis. We have designed this course with your needs in mind. The ABCs of ECGs: Back to Basics for Frontline Clinicians is a one-day program that was designed to help you understand basic electrocardiology and cardiac arrhythmias.

We encourage you to attend this conference with leading ECG specialists who have long experience in teaching ECG. The program below outlines the topics we have assembled to achieve our objectives.

We look forward to seeing you in December!


Ary L. Goldberger, MD

Over 96% of the course participants rated this course as “superior” or “above average” as compared to other postgraduate courses they have attended, placing this course among the highest-rated and most successful of Harvard CME courses. Participants cited in particular its excellent well-chosen ECG presentations as well as the ample opportunity for interaction with the faculty.


  • General internists
  • Hospitalists
  • Family practice
  • Primary care practitioners
  • Anesthesiologists
  • Emergency Medicine
  • Nurse practitioners
  • Physician assistants
  • Residents & Fellows
  • Critical care and pulmonary specialist
  • Nursing
  • ECG Technicians


This unique 1 day CME/CEU course will provide a practical step-by-step review of ECG interpretation for frontline clinicians in office and acute care settings. Emphasis will be on understanding the basis of ECG interpretation, clinical pearls, and the detection of potentially life-threatening problems (e.g., acute coronary syndromes, drug toxicity, atrial fibrillation, and other arrhythmias, hypertension and diabetes complications, valvular disease, long QT) and avoiding common pitfalls and errors.

The course will address the following yellow and red flag issues:

  • What is the physiologic basis of the ECG
  • How to systematically read an ECG: Step‑by‑Step Guide
  • How to avoid major ECG pitfalls and errors
  • How to recognize ST elevation MI (STEMI) and its simulators
  • What are management implications of ECG findings, including brady and tachycardias, long QT, etc.
  • How to use the ECG to diagnose metabolic abnormalities and drug toxicity

For questions, please call: (617) 667‑4267 or e‑mail: kjohnso3@bidmc.harvard.edu


Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Harvard Medical School designates this educational activity for a maximum of 6.75 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ECGs in Clinical Practice has been approved for 6.75 contact hours by the Alliance of Cardiovascular Professionals.


7:45‑8:15 Registration and Continental Breakfast
8:00‑9:00 Basic Principles: How to Read an ECG
9:00‑9:30 Artifacts, Lead Misplacements and Normal Variants
9:30‑9:45 Refreshment Break
9:45‑10:30 Chamber Enlargement and Bundle Branch Blocks
10:30‑11:15 Myocardial Ischemia/Infarction Patterns and Look‑alikes
11:15‑12:00 Bradycardias: Causes of Pauses
12‑1 Lunch On Your Own
1‑1:30 Metabolic Abnormalities and Drug Effects/Toxicities
1:30‑2:15 Tachycardias 1: PSVTs, Atrial Flutter and Atrial Fibrillation
2:15‑2:30 Refreshment Break
2:30‑3:00 Tachycardias 2: Ventricular & Other Wide Complex Tachycardias
3:00‑3:30 ICDs and Pacemakers: What Every Clinician Should Know
3:30‑4:15 Avoiding ECG Fumbles and Errors

*Please note: Program changes/substitutions may be made without notice.


Course Number #3014347

$325 (USD)
Residents*, Fellows in Training* and Allied Health Professionals: $225 (USD)
* A letter of verification from Department Chair must accompany registration form/payment for a reduced fee for Residents/ Fellows in Training.


All foreign payments must be made by a draft on a United States Bank or by Visa or MasterCard.

If paying by CHECK, please make payable to Harvard Medical School and mail with completed registration form to Harvard Medical School‑Department of Continuing Education, PO Box 825, Boston, MA 02117‑0825.

If paying by credit card, please register online.

Telephone or mail‑in registration with credit card payment is not accepted.

Inquiries should be directed to the above address, made by phone: (617) 384‑8600, Monday ‑ Friday, 10 AM to 4 PM (EST), or by email: hms‑cme@hms.harvard.edu

Upon receipt of your registration form an email confirmation from the HMS-DCE office will be sent to you. Therefore, be sure to include an email address that you check daily/frequently. Your email address is used for critical information about the course including: registration confirmation, course evaluation and certificate.


A handling fee of $60 is deducted for cancellation. Refund requests must be received by mail or fax one week prior to the course. No refunds will be made thereafter.


Hotel Commonwealth
500 Commonwealth Avenue
Boston, MA 02215
Phone: 866-784-4000


The Hotel Commonwealth
Hotel Commonwealth is the grand cornerstone of Boston's new Kenmore Square, the gateway to the city's many neighborhoods, cultural and historical attractions and steps away from world-renowned medical institutions and universities and Fenway Park. Offering classic style with a contemporary edge, this acclaimed independent 150-room luxury hotel features oversized, elegantly appointed guest rooms, gracious, personal service and is a destination unto itself with celebrated restaurants, a gallery of retail shops, and stylish lounge. Hotel Commonwealth amenities include spacious meeting and event facilities, complimentary Wi-Fi and exercise salon. A member of Small Luxury Hotels of the World.


Please do not make non-refundable airline reservations until you have been confirmed into your course. You can make your airline reservation by calling: the HMS Travel Desk toll free 1‑877‑4HARVMD (1‑877‑442‑7863) Monday ‑ Friday 9 am ‑ 8 pm (EST). From outside the U.S., Canada and Virgin Islands, please call 617‑559‑3764.


Known as America’s Walking City, Boston is home to many historic sites that date back to the American Revolution. You will be accessible to everything Boston has to offer including family attractions such as the New England Aquarium, Science Museum and the Boston Children’s Museum.

Other area attractions include the shops at Prudential and Copley Place Mall, Newbury Street, the fashionable Back Bay, Museum of Fine Arts, Boston Duck Tours, the Freedom Trail, Beacon Hill, Boston Common and Swan Boats to name just a few. Visitors to Boston are encouraged to stroll the Freedom Trail, a 2.5-mile red brick walking trail that passes sixteen nationally significant historic sites.

The Freedom Trail begins at Boston Common and ends at Bunker Hill, near the Charlestown Navy Yard and the home of the USS Constitution, the oldest commissioned ship afloat in the world.


The following rhythm strip from an elderly patient with syncope shows which ONE of the following?

  1. Atrial flutter with variable block
  2. Multifocal atrial tachycardia
  3. Atrial fibrillation with a rapid ventricular response
  4. Paroxysmal supraventricular tachycardia (PSVT)
  5. Sinus tachycardia with frequent atrial premature beats


The absence of multiple different discrete P waves excludes multifocal atrial tachycardia. No sinus P waves are seen, either. Note also that in the elderly (greater than 70 yrs), the probability of a sinus mechanism with heart rates greater than 140/min is quite low (less than 10%). See Pinto DS et al. BMC Cardiovascular Disorders 2003:3:7; available at: http://www.biomedcentral.com/content/pdf/1471-2261-3-7.pdf.

No flutter waves are seen. The fibrillatory activity also excludes paroxysmal supraventricular tachycardia due AV nodal reentry (AVNRT), atrio-ventricular reentry (AVRT) or atrial tachycardia (AT).

Important note: The diagnosis of atrial fibrillation is one of the major sources of errors in ECG interpretation, including high rates of false negative (overlooked) and false positive (overcalled) diagnoses. See, for example: Bogun F, et al: Misdiagnosis of atrial fibrillation and its clinical consequences. Am J Med 2004; 117:636, and Mant J, et al. BMJ 2007; 335:380.

Correct Answer is: C) Atrial fibrillation

Last update 07.12.10

Course #03014347

Course Dates for 2010-2011!

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    Ask A Question!

    We invite attendees to send questions for course faculty in advance. Submit a question to Dr. Goldberger via email and we will do our best to provide the answers during the course.

    You may also discuss program content with the Course Director, Ary L. Goldberger, MD, by emailing agoldber@bidmc.harvard.edu

    Meet the Faculty

    Ary L. Goldberger, MD
    Ary L. Goldberger
    , MD, is Professor of Medicine of Harvard Medical School and Director of the Margret and H.A. Rey Institute for Nonlinear Dynamics in Physiology and Medicine (http://reylab.bidmc.harvard.edu). Dr. Goldberger is also Associate Director, Division of Interdisciplinary Medicine and Biotechnology at Beth Israel Medical Center, Boston, MA and a member of the Cardiovascular Division at BIDMC. He has a longstanding commitment to medical education and is the single-author of two standard textbooks on electrocardiography, which have been translated into multiple languages. Dr. Goldberger and his colleagues have developed the most extensive, free teaching resource for electrocardiography on the Internet: ECG Wave-Maven (http://ecg.bidmc.harvard.edu). He is course director of a number of top-rated Harvard Medical School CME courses on ECG analysis for frontline clinicians. His research is in the cutting edge and interdisciplinary areas of complex and nonlinear systems and he is founding and current Program Director of the NIH-sponsored Research Resource for Complex Physiologic Signals ( http://www.physionet.org). He is also an Ellison Medical Foundation Senior Scholar in Aging.

    Next Person, MD
    Alexei Shvilkin
    , MD is Clinical Instructor in Medicine at Harvard Medical School. He is a Clinical Electro- physiologist and Clinical Director of the Arrhythmia Monitoring Laboratory at Beth Israel Deaconess Medical Center. He is also the Director of Research at ECG Core Laboratory of Harvard Clinical Research Institute. His research interests focus on mechanisms of myocardial repolarization, rhythm monitoring in atrial fibrillation ablation trials, and use of vectorcardiographic principles in ECG analysis.



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