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What is and how does an electrocardiogram work?

The electrocardiogram is a safe and simple detailed examination able to provide information regarding the state of the heart. It is used mainly to detect disorders of the heart rhythm (arrhythmias) and in the analysis of conditions with an insufficient blood supply to the heart (myocardial infarction and angina).

Likewise, it consists of recording in a format specially adjusted to the needs of the patients, in strips of millimeter paper, giving possible results, by the activity of the electrical current that is developing in the heart for a certain time. This study can be recorded and displayed continuously on a monitor similar to a television screen and is observed as a path that presents different waves corresponding to the path of electrical impulses through the different structures of the heart.

Types of Electrocardiogram

There are different types of electrocardiogram. These are indicated below

  • The standard electrocardiogram, also called a resting electrocardiogram, is done while the person is at rest.
  • The stress electrocardiogram is performed while the patient is in physical activity, showing the functioning of the heart under stress and allows diagnosing coronary heart disease. It is recommended that when the patient has been to heart surgery or had a heart attack, the exercise electrocardiogram can help the physician determine how much exercise can be done to the extent that it is safe. This test is sometimes called a stress test or treadmill test.
  • The 24-hour electrocardiogram is that study where an electronic recording device is used for 24 hours. Sometimes called Holter monitoring or ambulatory electrocardiography, which shows the heart’s activity for a day and night.

It is useful for showing irregular heartbeats (arrhythmia). If necessary, the device can be used for more than 24 hours.

  • Cardiac event recorders, which can record rhythm over a long period of time, include portable event recorders, which are used to record the heartbeat when the patient has symptoms, and these are implanted under the skin, at the chest level to continuously monitor the heartbeat.

Recommendations for the conduct of an electrocardiogram

Preparation for this test varies depending on the type of test to be done, such as the resting electrocardiogram, which is done in a doctor’s office and does not require any preparation. In the case of an exercise electrocardiogram, a 24-hour electrocardiogram or monitoring of cardiac events, you must go to the hospital to perform the test or to have the appropriate equipment applied to it and for this all the following instructions must be followed:

  • Wearing comfortable clothing and footwear.
  • Not eating heavy foods just before the test.
  • In some cases, you should be asked to take certain medications days before the electrocardiogram. Your doctor will tell you in advance if you should stop the medication.
  • The health care practitioner places several electrodes (small sensors that attach to the skin) on the arms, legs, and chest. Before doing this, you may need to shave or trim excess hair.
  • The electrodes are wired to a computer that records the heart’s electrical activity.
  • The activity is displayed on the computer monitor and printed on paper. The procedure it only lasts about three minutes.

The staff operating the team, technician or nurse, should explain to the patient what will happen before, during and after the procedure. This is your opportunity to understand what will happen, and you may find it useful to prepare a list of questions about the risks, benefits, and alternatives to the procedure. This will help you stay informed so that you can give your consent if they ask you to sign a consent form to carry out the procedure.

Finally, the study is also useful in monitoring heart disease when comparing with previous electrodes. Thus, it helps the physician to assess the evolution of a certain pathology and, sometimes, is very useful when establishing a specific treatment or modifying the dose of a drug that the patient may be taking.

Electrocardiographs KALSTEIN mark

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