Other types of ECG

Other types of ECG used in the evaluation of congenital heart disease include:

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Continuous or Ambulatory ECG. A Holter monitor is a portable ECG device that makes a continuous recording of the heart's electrical activity during a patient's daily routine. Usually worn for 24 to 72 hours, the Holter monitor, which is the size of a small deck of cards, can detect intermittent heart rhythm irregularities.

Event monitor. For irregular heartbeats that occur sporadically, the patient can carry a small, portable ECG device known as an event monitor. Event monitors may be the size of a small paperback novel, with electrodes that attach to the chest, or even as small as a credit card that merely needs to be placed upon the chest to pick up the electrical impulses. When symptoms arise, the patient turns on the event monitor to record the ECG. The recording can be transmitted across telephone lines.

Exercise ECG. Also known as a stress test, this procedure assesses how well your heart is working. It can detect coronary circulatory problems and abnormalities caused by insufficient blood and oxygen supply to the heart muscle. Rhythm abnormalities triggered by exercise may also be detected and used to identify exercise limits and develop an individual fitness program.

Minor preparations are required for an exercise test, usually involving diet restrictions. The exercise ECG is performed with the individual on a treadmill or stationary bike, so wear comfortable clothing and athletic shoes. The exercise portion of the test usually lasts five to 15 minutes; with the entire test lasting 30 to 40 minutes. The exertion level will increase gradually at regular intervals until the peak exertion level, as determined by the healthcare team, is met. Shortness of breath and sweating are normal, but be sure to tell the healthcare team if you experience chest pain, severe shortness of breath, dizziness or leg cramps. The ECG readings are recorded continuously before, during, and after exercise. Changes in blood pressure and exercise capacity are also recorded.

Your doctor may also want to measure oxygen consumption to determine how well the heart and lungs are working together. This requires wearing a nose clip to force you to breathe through your mouth and a special mouthpiece that measures the amount of oxygen you breathe during exercise. An exercise ECG carries a small risk because it involves increasing the workload of the heart. The chances of suffering heart problems during the test are remote. For instance, 48 individuals out of 10,000 people taking an exercise ECG experience a serious heart rhythm problem; 3.5 in 10,000 experience a heart attack. Moreover, the healthcare professionals administering the test are trained to diagnose and treat these kinds of complications appropriately and quickly.