5. 3 lead ECG monitoring
• Used for continuous monitoring of heartbeat, heart rate, and heart rhythm in
critical situations like when the patient is under anesthesia, in surgery or being
transported in an ambulance to a health center.
• Requires the use of 4 electrodes that are placed on each of the limbs.
• Used in combination with other medical devices like an
echocardiogram.
6. • Occasionally a 5 lead ECG is also used for monitoring purposes.
• It uses 4 electrodes like a 3 lead ECG with an additional 5th electrode placed on the
chest.
• Usually these devices do not produce a print out of the electrocardiogram and
may not store the information for further review.
5 lead ECG monitoring
7. Holter Monitor Test
• A portable ECG monitor that can be worn by a patient for duration of 24 to 48 hours while
the device continuously monitors the heart rhythm.
• Fewer leads than a normal clinical ECG machine.
• The patient is free to move around and go around their usual daily routines.
• Useful for detecting abnormalities in heart rhythm that could be easily missed during a
clinical ECG test, which last less than a minute.
8. Cardiac event recorder
• The symptoms may not appear during the ECG and a Holter Monitor test.
• In such cases, a Cardiac Event Recorder can be worn continuously for an extended period of
time (2-4 weeks).
• The size of a deck of cards and cables to the recording device connect the electrodes.
• Unlike the Holter Monitor, it continuously record the heart rhythm. When the patient is
experiencing the symptoms, he or she can activate
• The recorder and the device will record the incident.
9. • A compact USB pen drive sized medical device to monitor the heart function.
• Attached to the surface of the skin around the area of the patient's heart.
• Continuously records the heart rhythm for a certain duration, depending on the memory capacity of the device and when
the device memory is full, it starts overwriting from the beginning of the recording, Hence the name, loop recorder.`
• An event recorder can miss the starting of an abnormal heart activity due to the delay in initiating the record function, A
loop recorder has a record button when pressed can save the immediate few minutes prior to the start of the abnormal
heart activity and continue recording for few additional minutes and then stop recording. This way the entire episode is
captured and not overwritten.
• When the patient experiences an abnormality the recorder can be set to
automatically record the incident or can manually instruct the device to record the
incident.
• A loop recorder can be worn for many days or weeks (up to 30 days), while the
patient goes around their routine day-to-day activities. It can be removed during
showering or swimming.
Cardiac loop recorder
10. • Miniature loop recorder that can be implanted between the chest skin and the rib cage, above the
heart.
• Like the loop recorder it can be programmed to automatically start recording
when an abnormality is detected in the heart rhythm.
• Activated by an external trigger device that the patient can carry around in the form of a wrist
band or a remote control.
• More suitable for patients who experience symptoms that cannot be monitored easily within the 30
days’ period of a normal external loop recorder.
• Have a battery life of up to 3 years and suitable for long
term continuous monitoring in high-risk patients.
Implantable Loop recorder(ILR)
11. Also known as Cardiac stress test or treadmill test.
• In patients that can walk, the test is conducted on a treadmill.
• The patient is connected to an ECG monitoring machine and is asked to start
walking on the treadmill.
• As the test progresses, the intensity of the physical activity is increased.
• Patients with walking disability can use hand pedaling stationary bike.
• Pharmaceutical drug is used to simulate the same effect in disabled patients.
• Designed the study how the patient's heart can cope up with added external stress.
• Abnormalities on ECG during the test can be an
indication of underlying heart disease.
• The test is useful for overall assessment of a person's
health and is often used by professionals like Aviators
and Astronauts during their routine health checkups.
Stress ECG
12. • The standard ECG has 12 leads. Six of the leads are considered “limb leads” because they
are placed on the arms and/or legs of the individual.
• The other six leads are considered “precordial leads” because they are placed on the torso
(precordium).
• The six limb leads are called lead I, II, III, aVL, aVR and aVF. The letter “a” stands for
“augmented,” as these leads are calculated as a combination of leads I, II and III.
• The six precordial leads are called leads V1, V2, V3, V4, V5 and V6.
Electrodes and leads
13. Leads that are routinely used for standard 12 lead ECG
Standard Limb Leads
Augmented Limb Leads
Precordial Leads
Wilhem Einthoven
E Goldberger
Frank Wison
