Ultimate guide to the ECG test

What is an ECG test?

An electrocardiogram (ECG), is a test that records the electrical activity of your heart. It’s one of the most widely used medical tests in the world, found in doctors’ offices, operating rooms, and ambulances.

The ECG test result gives medical professionals a snapshot of your heart activity and helps them to assess your heart health, and detect possible risks or abnormalities.  

Person getting an ECG test and a clinician printing a trace from an ECG machine

The benefits of ECG

The technology for ECG is both widely available and highly informative, providing medical professionals with data that can be related to a variety of heart conditions. The procedure itself is safe, inexpensive, and non-invasive.

A doctor would use an ECG to look at the

  • heart rhythm, 
  • heart rate, 
  • heart axis (the direction of the electrical activity), 
  • rhythm disturbances.

The history of ECG

The first ECG was developed by the Dutch physiologist Willem Einthoven in 1903. It was initially only referred to as an EKG, after the German spelling for elektrokardiogram. This first ECG machine recorded the signals of the heart using a string galvanometer — an instrument that measures electrical charge. The string was kept under a very strong magnetic field, and it would move when an electrical current from the heart passed through it. 

Einthoven was able to monitor the heart’s response to respiratory changes and was even able to determine the size and location of the heart from ECG data alone. These developments proved how useful the technology could be.

An early commercial ECG machine, built in 1911

Throughout the following decades, ECG technology would improve, becoming more accurate at recording these signals. By the late 1960s, most large hospitals had adopted modern electrocardiogram machines. From then on, the machines were adapted to become more compact, accessible, and versatile. 

Today, there are ECGs that can be operated from personal devices and implantable devices such as loop recorders and pacemakers. The information they provide, for doctors and medical researchers alike, remains a critical part of understanding the human heart and monitoring its condition.

Why is an ECG test done?

In most cases, ECGs are performed when a person has noticeable symptoms related to their heart activity which may indicate a heart abnormality such as

  • having a rapid pulse, 
  • lightheadedness or dizziness, 
  • heart palpitations (feeling of your heart racing, fluttering or skipping beats), or
  • shortness of breath.

A doctor may recommend the test to check for arrhythmias, coronary artery disease, previous heart attacks, or the status of certain heart diseases. If there is a family history of heart problems, an ECG may also be recommended regardless of any symptoms experienced.

Typically, ECGs will record the heart rhythm and heart rate. These two factors provide the most essential data for the test, which a doctor will use to interpret the condition of the heart.

Advantages and disadvantages of the ECG test

Advantages

  • Safe and non-invasive
  • ECG equipment is widely available
  • Highly informative procedure used to examine a variety of symptoms and diagnose many heart conditions
  • Allows doctors to easily obtain basic information about your heart’s activity

Disadvantages

  • Sometimes requires shaving areas on the body where electrodes are placed 
  • Sometimes not enough to differentiate events that can be confused with symptoms of brain conditions

Specialised groups of cells generate and transmit an electrical impulse that stimulates the heart (shown in yellow) to pump blood

How does an ECG work?

The top right chamber of the heart contains a group of specialised cells that initiate a heartbeat. When generating a normal heartbeat, these cells create an electrical impulse that causes the surrounding cells to do the same in a domino-style fashion throughout the remaining chambers of the heart. 

As the wave of electrical stimulation passes over different sections of the heart in what is normally a highly coordinated fashion, the chambers contract which causes the heart to pump blood. This electrical activity is recorded by the ECG machine, where it appears as a series of waves on a trace.

How is an ECG test interpreted?

A typical ECG test uses 12 leads attached to the body. Analysing a 12 lead ECG trace is like putting together a puzzle. A clinician will measure the distances between different segments of a heartbeat, evaluate how far apart one beat is from the next, and then assess the orientation of beats in each of the 12 leads.

A normal 12 lead ECG trace

Next, the clinician will look for extra beats and dropped beats before determining the health of the heart’s function. At the end of this process, the ECG report will give a fairly detailed description that provides a baseline for healthcare professionals to better understand the condition.

Interpreting the traces can give clues about

  • irregular heart rhythms, 
  • reduced blood flow, 
  • damage to the heart, 
  • inflammation related to the heart, 
  • abnormal blood electrolytes, and 
  • many other heart-related conditions.

When should you get an ECG test?

Typically, your doctor will recommend an ECG if you’re experiencing symptoms that could be related to a heart problem. 

This may include symptoms like

  • fainting,
  • dizziness,
  • lightheadedness,
  • chest pains,
  • shortness of breath, or
  • seizures.

If you are experiencing the above symptoms and are having a medical emergency, please call ‘000’.

These symptoms may or may not be related to a cardiovascular issue, but taking an ECG test is one of the simplest ways to determine whether or not that is the case.

A person experiencing chest pains, headache, shortness of breath

If you experience chest pains, dizziness, or any of the symptoms mentioned above consult your doctor as soon as possible. If you are having a medical emergency please call ‘000’.

When to seek medical advice

If you’ve experienced any of the above-mentioned symptoms you should contact a healthcare provider as soon as possible to begin diagnosing the issue.

If you’ve had a history of heart disease in your family or may have suffered a heart attack in the past, then it’s important to seek medical advice as soon as you begin to notice any of the above symptoms. 

You may need a series of tests to determine the specific nature of your condition, including an electroencephalogram (EEG) in some cases. 

For people who have recently experienced a seizure, getting an ECG alongside an EEG may be useful. This is due to the fact that the symptoms of brain and heart conditions may be similar, but also because brain and heart conditions may overlap, and ruling out one or the other is often essential before deciding on how to diagnose and provide treatment.

 

9 questions to ask your doctor if you think you’re having seizures. Download our “Preparing for your appointment” worksheet.

 

Stress or exercise ECG. A person is connected to electrodes and exercising. The clinician on the left is taking the blood pressure

Stress or exercise ECG

Types of ECG tests

  • Resting ECG — performed while lying down and is the most common type. This is performed at a clinic or hospital and takes around 10 minutes
  • Stress or exercise ECG – carried out while on an exercise bike or treadmill. This is performed at a clinic or hospital and goes for around 30 minutes
  • Ambulatory ECG (also known as Holter monitoring) – only 3-5 electrodes are connected to a small, portable device allowing freedom of movement. This testing is primarily done in the home and lasts for 24 hours
  • Long-term ambulatory ECG (also known as multi-day Holter monitoring) — takes place over a longer period of time and can only be done with a portable device. This testing is primarily done in the home and lasts between 3 and 10 days

 

Holter monitor device used for ambulatory ECG testing with 3 leads

Holter monitor device used for ambulatory ECG testing with 3 leads

How to prepare for an ECG test

ECG tests are non-invasive and painless. Typically, you’ll be asked to lay down while the test is administered. During that time, you may be asked to remain still by breathing normally and trying to relax. At the end of the test, the electrodes are removed and the results will be reviewed by your doctor and explained to you at your follow-up appointment.  

Before starting the test, there are a few things you should do to prepare in order to ensure an effective and comfortable test experience. The following suggestions can be treated as a checklist for ECG tests in a hospital or clinic.  

  • Avoid oily skin creams and other topical products, as these can make it difficult to attach the electrodes to your skin
  • Keep your clothing simple and avoid full-length hosiery or bodysuits. Remember that you will need access to your arms, legs, and chest in order to attach the electrodes
  • Breathe normally. Though you will be asked to lay as still as possible, you should also breathe as you normally would so that your heart rate can be measured in its normal state

 

Illustration of person getting an ECG test

Preparing for an ECG with Seer Medical

Seer Medical provides long-term video-EEG-ECG testing in the home. Our testing involves a portable, wearable ambulatory EEG-ECG device and the duration is between 3 and 10 days. 

Preparing for your appointment with us is easy. Simply avoid creams on your chest and wear a button-up or loose-fitting shirt to your connection appointment where 3 ECG stickers will be attached to your chest, and electrodes will be attached to your scalp. You’ll go home with the monitoring equipment for the duration of your study.

At the end of monitoring, you’ll come back for a disconnection appointment and our trained scientists and cardiologist will review the data that was recorded while you were at home. The results of the tests are sent to your doctor within four (4) weeks of the end of testing.

What makes our ECG test different from others?

Longer investigation

Typically, ECG tests are performed in a clinical setting separately from an EEG and other kinds of tests. 

The symptoms described by people requiring ECG testing are often irregular and require a diagnostic test that allows for a longer investigation. Because Seer Medical’s test is completed over a longer period of time, there’s a better chance of recording an event if it occurs.

Although 12 lead ECGs are incredibly informative, they are too restrictive for prolonged testing. Seer Medical testing utilises three lead ambulatory ECG monitoring as this is more comfortable for longer periods and provides sufficient information.

A complete view 

Seer Medical’s testing is designed to be done from the comfort of your own home in coordination with EEG tests and video recording

It’s a unique form of testing that provides a detailed snapshot of your brain and heart activity simultaneously, giving you and your doctor a more complete picture of your events. 

Tests like ours are not only convenient, but they also offer several advantages over more routine ECG and EEG tests. Video-EEG-ECG monitoring offers a comprehensive and complete recording of your heart and brain activity and the way your body behaves during an event. 

With this kind of data, it’s easier to identify and rule out certain conditions to provide an accurate diagnosis so you can get the treatment plan you need.

The Seer Medical Process. Click the image to find out how our service works. Referral: See your doctor and get a referral for at-home video-EEG-ECG. Within 2 days, we receive your referral and call you to book your appointment. Connection and monitoring (3-10 days): Come to your connection appointment at a Seer Medical clinic. You will then go home for the monitoring duration specified by your doctor (3-10 days). After your monitoring, return to the Seer Medical clinic for your disconnection appointment. Results (4 weeks): Our clinical scientists review your data. A neurologist and cardiologist finalise your report. The report is then sent to your referring doctor. You will review the findings with your referring doctor who will provide the final diagnosis. From here, your treatment plan can be created or adjusted.

FAQ

Q: Is an ECG the same as an EKG?

A: Yes. The abbreviations ECG and EKG both refer to electrocardiograms. EKG is based on the German spelling whereas ECG is based on British/Australian English spelling. They are often used interchangeably in most languages.

Q: Are there any risks or side effects?

A: Some patients may experience a mild skin rash where the electrodes were placed, however, these mostly disappear after a few days. There are no known side effects from the test itself as it is a non-invasive procedure.

Q: Why is ECG done with EEG?

A: Doing these tests together helps create a comprehensive picture of your brain and heart health. This is helpful for ruling out heart or brain conditions and narrowing in on conditions with a single test.

Q: Do I have to shave before having an ECG?

A: Yes, it is recommended to shave your chest area on the morning of your appointment. A clean-shaven chest ensures that the ECG stickers don’t come off and ensures higher recording quality.

 

Get in contact with our friendly team to find out if Seer Medical’s service is suitable for you.