Types of Electrocardiography

Introduction

Electrocardiography (ECG or EKG) is a diagnostic tool that records the electrical activity of the heart over a period of time. It is widely used to detect heart conditions such as arrhythmias, myocardial infarction, and other cardiac disorders.

Main Types of Electrocardiography

1. Resting ECG

• Performed while the patient is lying down in a relaxed position.
• Provides a baseline measurement of heart rhythm and electrical activity.
• Used for diagnosing arrhythmias, conduction disturbances, and structural heart disease.

2. Exercise (Stress) ECG

• Conducted while the patient exercises on a treadmill or stationary bike.
• Helps detect ischemic heart disease and assess exercise tolerance.
• Often used to evaluate angina and detect silent coronary artery disease.

3. Holter Monitoring

• A portable ECG device worn for 24 to 48 hours (or longer).
• Allows continuous ECG recording during daily activities.
• Useful for identifying intermittent arrhythmias and heart rate variability.

4. Event Monitoring

• Similar to Holter monitoring but activated by the patient when symptoms occur.
• Used for detecting transient or infrequent arrhythmic events not captured in a standard ECG.

5. Telemetry Monitoring

• Continuous ECG monitoring while a patient is hospitalized.
• Enables real-time tracking of cardiac activity, especially in critical care units.

6. Signal-Averaged ECG (SAECG)

• A specialized form of ECG that detects subtle, high-frequency electrical abnormalities.
• Helps in the assessment of arrhythmic risk in patients with previous myocardial infarction.

7. Vectorcardiography (VCG)

• A technique that records the electrical activity of the heart in three-dimensional space.
• Used in research and for enhanced detection of conduction abnormalities.

8. Intracardiac Electrocardiography

• An invasive method used during electrophysiological studies.
• Provides detailed electrical mapping of the heart for arrhythmia diagnosis and treatment.

Conclusion

Electrocardiography is a critical diagnostic tool in cardiology. Different types of ECG serve specific purposes, from routine screenings to in-depth arrhythmia analysis. The choice of method depends on the patient's symptoms and suspected cardiac conditions.

Source recommendations

1. American Heart Association Guidelines for Electrocardiography

1. https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/electrocardiogram-ecg-or-ekg
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.106.180200
5. https://elearning.heart.org/course/1211

2. European Society of Cardiology Guidelines on Cardiac Monitoring and ECG Interpretation

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines
2. https://www.ahajournals.org/doi/10.1161/cir.0000000000000527
3. https://www.escardio.org/static-file/Escardio/Guidelines/Documents/ehaa612.pdf
4. https://academic.oup.com/eurheartj/article/39/21/1883/4939241
5. https://www.jacc.org/doi/10.1016/j.jacc.2017.01.015