The electrocardiogram, also referred to as ECG, 12-lead ECG, or EKG, is a non-invasive diagnostic test that evaluates your heart’s electrical system to assess for heart disease. It uses flat metal electrodes placed on your chest to detect the electrical charges generated by your heart as it beats, which are then graphed. Your doctor can analyze the patterns to get a better understanding of your heart rate and heart rhythm, identify some types of structural heart disease, and evaluate cardiac efficiency.
In a conventional 12-lead ECG, ten electrodes are placed on the patient’s limbs and on the surface of the chest. The overall magnitude of the heart’s electrical potential is then measured from twelve different angles (“leads”) and is recorded over a period of time (usually ten seconds). In this way, the overall magnitude and direction of the heart’s electrical depolarization are captured at each moment throughout the cardiac cycle. The graph of voltage versus time produced by this noninvasive medical procedure is an electrocardiogram.
During each heartbeat, a healthy heart has an orderly progression of depolarization that starts with pacemaker cells in the sinoatrial node, spreads throughout the atrium, passes through the atrioventricular node down into the bundle of His and into the Purkinje fibers, spreading down and to the left throughout the ventricles. This orderly pattern of depolarization gives rise to the characteristic ECG tracing.
To the trained clinician, an ECG conveys a large amount of information about the structure of the heart and the function of its electrical conduction system. Among other things, an ECG can be used to measure the rate and rhythm of heartbeats, the size, and position of the heart chambers, the presence of any damage to the heart’s muscle cells or conduction system, the effects of heart drugs, and the function of implanted pacemakers.