ELECTRODARDIOGRAM (ECG)

DEFINITION An electrocardiogram (ECG) is a test that records the electrical activity of the heart. ECG is one of the sim lest and fastest roced!res !sed to eval!ate the heart. "efore the test# electrodes (small# lastic atches) are laced at certain locations on yo!r child$s chest# arms and legs. After the electrodes are connected to the E%G&ECG machine 'y lead (ires# the electrical activity of yo!r child$s heart is meas!red# inter reted and rinted o!t for the hysician to e)amine

*o( the test is erformed +o! (ill 'e as,ed to lie do(n. The health care rovider (ill clean several areas on yo!r arms# legs# and chest# and then attach small atches called electrodes to the areas. It may 'e necessary to shave or cli some hair so the atches stic, to the s,in. The n!m'er of atches !sed may vary. The atches are connected 'y (ires to a machine that t!rns the heart$s electrical signals into (avy lines# (hich are often rinted on a er. The test res!lts are revie(ed 'y the doctor. +o! !s!ally need to remain still d!ring the roced!re. The health care rovider may also as, yo! to hold yo!r 'reath for a fe( seconds as the test is 'eing done. Any movement# incl!ding m!scle tremors s!ch as shivering# can alter the res!lts. -o it is im ortant to 'e rela)ed and relatively (arm d!ring an ECG recording. -ometimes this test is done (hile yo! are e)ercising or !nder minimal stress to monitor changes in the heart. This ty e of ECG is often called a stress test.

.hy the test is erformed An ECG is !sed to meas!re/

Any damage to the heart *o( fast yo!r heart is 'eating and (hether it is 'eating normally The effects of dr!gs or devices !sed to control the heart (s!ch as a acema,er) The si0e and osition of yo!r heart cham'ers

An ECG is !s!ally the first test done to determine (hether a erson has heart disease. +o!r doctor may order this test if/

+o! have chest ain or al itations +o! are sched!led for s!rgery +o! have had heart ro'lems in the ast +o! have a strong history of heart disease in the family

There is no reason for healthy eo le to have yearly ECG tests.

PROCEDURE

+o! (ill 'e as,ed to remove any 1e(elry or other o'1ects that may interfere (ith the roced!re.

+o! (ill 'e as,ed to remove clothing from the (aist ! . The technician (ill ens!re yo!r rivacy 'y covering yo! (ith a sheet or go(n and e) osing only the necessary s,in.

+o! (ill lie flat on a ta'le or 'ed for the roced!re. It (ill 'e im ortant for yo! to lie still and not tal, d!ring the roced!re# so as not to interfere (ith the tracing.

If yo!r chest# arms# or legs are very hairy# the technician may shave or cli small atches of hair# as needed# so that the electrodes (ill stic, closely to the s,in.

Electrodes (ill 'e attached to yo!r chest# arms# and legs. The lead (ires (ill 'e attached to the s,in electrodes. Once the leads are attached# the technician may ,ey in identifying information a'o!t yo! into the machine$s com !ter.

The ECG (ill 'e started. It (ill ta,e only a short time for the tracing to 'e com leted. Once the tracing is com leted# the technician (ill disconnect the leads and remove the s,in electrodes.

EXAMINATION ON-LINE MODE This mode is a!tomatically selected after the !nit2s s(itch on. In this mode# the screen dis lays the recorded ECG signal and other information/ -elected rint rofile ( a!to# man!al# rofile# long) *eart rate 3a er s eed -ensitivity -et filters 4oose leads# if any Name of dis layed lead ( only (hen changed5 ress the monitor leads '!tton) N!m'er and names of the leads to 'e rinted ( 6T model) 7 the -D8# -D9# -D:# 6D# 6D9 models dis lay this information only (hen it is set ( ressing the n!m'er of leads and& or select leads '!tton)

ECG c!rve Error messages/ 'attery ( discharged 'attery)# a er ( no a er)# ress!re ( rinted head !nloc,ed).

.hen the 8;5second record is saved into the memory the e<!i ment dis lays saving ( or meas!ring in some soft(are versions) on the screen.

Selecting a pro ile The = rofiles2 are re5set recording and rinting arameters for easy and fast

recording and rint. Their factory reset arameters can 'e changed in the men!. In addition to the rofiles a!tomat ( the a!to '!tton) and man!al ( the man '!tton) the !ser can define a n!m'er of other rofiles ( ress the rofile '!tton re eatedly to see all rofiles). The resent rofile arameters can 'e changed at any time 'efore and d!ring recording. 3ress the res ective '!ttons. 3ress the man!ally if the sto '!tton is ressed. !i"ing t#e electro$e% The <!ality of record is also de endant on the contact 'et(een the electrode and the atient2s s,in. For 'est contact/ 6a,e s!re the s,in is (arm and atient rela)ed. >!' the s,in (ith alcohol 'efore fi)ing the electrodes. ?se eno!gh ECG gel on the electrode. rint '!tton to start recording. The recording terminates a!tomatically after the resent time ella ses or

Reco&&en$e$ or$er to i" t#e electro$e%' First fi) the N electrode to the right leg. Then fi) the other lim' electrodes ># 4# F Finally fi) the chest electrodes in the order/ @A5@B5@85@95@:5@C

Li&( electro$e% > D red 4 D +ello( F D Green N D "lac, C#e%t electro$e% @8 D red @B D yello( @9 D green @A D 'ro(n @C D 'lac, @: @: D violet 5 at height of @A in the middle a)illary line 5 Ath intercostals to the right of stern!m 5 Ath intercostals s ace to the of stern!m 5 'et(een @B and @A 5 Cth intercostals in 6DC4 line 5 at height of @A in the front a)illary line# evenly 'et(een @A and 5 right arm 5 left arm 5 left leg 5 right leg

EXAMINATION PROCESS -(itch the !nit on 'y the on&off '!tton. Enter the name of the atient to 'e rinted in the record (if desired)/ (o tional) -elect rint rofile D e.g. a!to/

Fi) the electrodes. 6a,e s!re that all leads are correctly connected and that ECG does not re ort any loose leads. Chec, the signal on the dis lay. 3ress rint/ E"a&ination In T#e A)to&at Pro ile S*ITC+ ON the !nit5!IX ELECTRODES-SELECT PRO!ILE 'y a)to '!tton (!nit set! )5 START RECORDING 'y print '!tton5 AUTOMATIC TERMINATION "efore recording# yo! can change the follo(ing arameters/ 3rinted ECG leads# format of leads (8)8B# B):# 9)AE) 3a er s eed -ensitivity Active filters (m!sc!lar# AD- and mains filter)

The e)amination (ill sto a!tomatically after the reset time7 or ress the sto '!tton to terminate the e)amination at any time. If the diagnosis and analysis has not 'een reset for rint# yo! can still rint it D ress anal,%e (only (ith DIAGNO-TIC- mod!le). To re rint the record# set the rint o tions !sing the ,ey'oard and ress cop,. For a!tomatic recording of another atient# ress print. E"a&ination In T#e Man)al Pro ile S*ITC+ ON the !nit5 !IX ELECTRODES5 SELECT PRO!ILE 'y &an '!tton (!nit set! )5 START RECORDING 'y print '!tton5 STOP recording 'y %top '!tton. "efore recording# set the follo(ing arameters (or change them d!ring recording)/ 3a er s eed D &&-% '!tton -ensitivity5 &&-&. '!tton N!m'er of leads5 n)&(er o lea$% '!tton 4eads to 'e rinted5 %elect lea$% '!tton Filters5 ilter and $ri t '!ttons

3ress print to start. 3ress %top to sto recording. The last 8;5 sec stri has 'een saved in the memory.

3ress anal,%e to rint inter retation and analysis (only (ith DIAGNO-TIC- mod!le). To re rint the last 8; sec record# set the rint o tions and ress cop,. For a!tomatic recording of another atient# ress print.

+eart Rate 9;;&A FGC ' m

R,t#& >eg!lar

P *a/e (occ!rance and form) Normal

PR inter/al (in seconds) A 'o) H ;.;A s F;.8: s

0RS (in seconds) B 'o) H ;.;AC F ;.;I s

Ty e of sin!s rhythm/ Normal -in!s >hythm

Ty e of sin!s rhythm/ A'normal sin!s >hythm CONCLUSION

+eart Rate

R,t#&

P *a/e (occ!rance and form) @isi'le 'efore each J>- com le)

PR inter/al (in seconds)

0RS (in seconds)

300/2.2 136.3 bpm

regular