Types of ECG

Introduction

Electrocardiography (ECG) is a diagnostic test that measures the electrical activity of the heart. Different types of ECGs are used to evaluate heart function in various contexts.

1. Resting ECG

A standard 12-lead ECG performed while the patient is at rest. It is used to detect arrhythmias, ischemic changes, and structural abnormalities.

2. Stress ECG (Exercise ECG)

Conducted while the patient exercises on a treadmill or stationary bicycle. It helps detect exercise-induced ischemia and evaluate heart function under stress.

3. Holter Monitoring (24-48 Hour ECG)

A portable device records the heart’s electrical activity continuously for 24-48 hours. It is useful for detecting intermittent arrhythmias and prolonged abnormalities.

4. Event Recorder

Similar to Holter monitoring but used for longer periods (weeks to months). The patient activates the device when symptoms occur, making it useful for infrequent arrhythmias.

5. Implantable Loop Recorder

A small device implanted under the skin that continuously monitors heart rhythm for months or years. It is used when syncope (fainting) or unexplained arrhythmias need further evaluation.

6. Telemetry Monitoring

Continuous ECG monitoring in hospitalized patients, typically used in critical care settings for real-time heart rhythm evaluation.

Conclusion

Different types of ECG tests serve various diagnostic purposes. The choice depends on the patient's symptoms and specific clinical concerns.

Source recommendations

1. American College of Cardiology/American Heart Association (ACC/AHA) Guidelines for ECG Interpretation

  1. https://www.acc.org/Guidelines
  2. https://www.ahajournals.org/doi/10.1161/circulationaha.108.191095
  3. https://pubmed.ncbi.nlm.nih.gov/19281932/
  4. https://www.ahajournals.org/doi/10.1161/circulationaha.108.191098
  5. https://www.jacc.org/doi/10.1016/j.jacc.2022.08.750

2. European Society of Cardiology (ESC) Guidelines for Ambulatory ECG Monitoring

  1. https://www.escardio.org/static-file/Escardio/Guidelines/Documents/ehaa612.pdf
  2. https://academic.oup.com/eurheartj/article/39/21/1883/4939241
  3. https://www.escardio.org/The-ESC/Press-Office/Press-releases/extended-monitoring-detects-more-arrhythmias-in-hypertrophic-cardiomyopathy
  4. https://academic.oup.com/eurheartj/article/35/39/2733/853385
  5. https://www.heartrhythmjournal.com/article/s1547-5271(17)30415-0/fulltext

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