The ECG or EKG (terms used interchangeably) is one of the most common non-invasive tests performed in the physician office today with close to 38 million performed each year. The electrocardiograph is an essential diagnostic tool for virtually every family practitioner, general practitioner, internist, DO and cardiologist in the United States.
What’s an ECG or EKG?
An ECG or EKG measures the electrical impulses that control contraction and relaxation of the heart. The familiar waveform pattern is a visual record of the amount of voltage activity generated by the heart and the time required for that activity to travel through the heart. Most heart problems can be identified from the abnormalities in heart rate, rhythm, and the ECG or EKG waveform pattern.
An ECG or EKG is usually done to screen patients for heart disease and to help diagnose coronary problems in high-risk or symptomatic patients. The American College of Cardiology recommends that all adults over 40 receive a baseline test followed up every five years in non-symptomatic patients and annually in high-risk patients.
Available Modalities
Stand-alone ECGs. These are traditional stand-alone, hard copy devices that perform ECGs only. Today, newer versions of the autonomous technology are beginning to mimic PC-based ECGs with the ability to be connected with electronic medical records software or practice management systems.
PC Based EKGs. These are compact devices that plug directly into a PC allowing the operator to view live ECG tracings. These devices, in general, enable the user to record ECGs and provide automatic measurements, interpretations and manage patient records. Records are stored on a local PC, a remote central database, directly into an EMR (Electronic Medical Record), or can be e-mailed to an out-of-network physician for review.
Indications for Performing an ECG or EKG
- Physical exam
- Angina
- Hypertension
- Chest pain
- Family history of heart disease
- Baseline study
- Preoperative screening
- Exercise prescriptions
What Physicians use ECG’s or EKGs?
- Family and general practitioners
- Cardiologists
- DOs
- Internal medicine physicians
- Pediatricians
- Surgery centers
- Emergency clinics
- Home health providers
- Nursing home
Key Terms
Waveform – Refers to the “peak and valley” tracing of the heart’s electrical activity.
12-lead ECG or EKG – The standard for diagnostic ECGs. The instrument provides 12 different views of the heart. Usually, three lines with 2.5 seconds of each lead and lead two rhythm strip at the bottom of the page.
Multi-Channel ECG or EKG – The ECG can record 3, 4, 6 or 12 of the lead views at one time on 8 1/2 x 11” paper, for secure storage.
Interpretation – The ability to provide a suggested interpretation of the tracing with incorporated computer software, which is also referred to as an instant second opinion.
Measurements – The ability to measure voltage, wave duration, and slope, intervals, and segments.
Rhythm strip – A continuous recording of one lead view done to check the cardiac rhythm.
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