We are pleased to announce to our readers a new weekly ECG section for Circulation. Similar to the Circulation Facebook page, an ECG and brief clinical history will be presented. The following week there will be a detailed discussion of the ECG findings and reference to appropriate labels that point out the findings useful for accurate interpretation.
The ECG has been an important part of medical practice, in continuous use since it was first reported in 1901 by Willem Einthoven. As one of the oldest technologies in medicine, it remains one of the most frequently used laboratory tests central to clinical practice. An ECG is frequently obtained in hospital patients, as a preoperative test, in patients seen in clinics and physician offices, and in the emergency department. Even with the development of more sophisticated tests for evaluation of the heart, the ECG continues to be a central component in the evaluation of cardiac as well as many noncardiac disorders. It can be quickly and easily obtained anywhere, is noninvasive and inexpensive, and is highly cost effective. It provides immediate information that is often important, if not essential, for the management of patients, and is often used not only for diagnosis and treatment, but also for epidemiological population studies and risk stratification. The ECG is an important tool in the development of new drugs and technologies. As technology advances and the physician strives and often struggles to keep up with the many new developments in cardiology and medicine, the ECG is timeless because it is a technology that does not change. The basics of ECG analysis and interpretation are the same today as they were 60 years ago. As such, ECG interpretation remains as a time-honored, fundamental skill in the practice of cardiology.
Despite its central role in medicine, teaching of ECG fundamentals and ECG analysis has often been ignored, or at best suboptimal, as medical training has often emphasized newer and more high-tech modalities. As a result, physicians have become insecure in their ability to interpret the ECG for themselves, often depending on machine interpretation. ECG analysis requires an understanding of what is normal so as to identify what is abnormal. It also requires a careful inspection of the waveforms so as to identify abnormalities (often subtle) that are of importance. This requires a systematic approach to ECG analysis. In addition, the ECG provides valuable information about the underlying basics of cardiac electrophysiology. Understanding these fundamental electrophysiological concepts results in more expertise in ECG analysis.
The purpose of this new ECG section is to present a clinical ECG for analysis and then provide a detailed discussion of the ECG findings and basic electrophysiological concepts, pointing out the relevant abnormalities that are of importance for establishing the correct ECG diagnosis. We hope that you find this section a useful addition to Circulation.
- © 2013 American Heart Association, Inc.