During a long-term ECG, a patient’s heart activity is monitored over a period of 24 or 48 hours. For this purpose, the patient is provided with a portable ECG device that they must wear on their body throughout the monitoring period. The results of the test allow the doctor to identify conditions such as arrhythmias in the patient’s daily life.
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"We need to examine your heart function more closely and perform a long-term ECG. I'm referring you to a cardiologist for this." Many patients hear these words from their primary care physician every day, for example, when angina pectoris is suspected
The abbreviation ECG stands for electrocardiography. It is a method doctors use to examine heart activity.
The first electrocardiogram was recorded from a dog. The English physiologist A. D. Wailer experimented with the method in the 1880s. At the beginning of the 20th century, the Dutch physician W. Einthoven further improved the technique. Since then, it has been able to provide important data for human health.
Einthoven was awarded the Nobel Prize in Medicine in 1924 for this work.
With every heartbeat, the heart muscle contracts, pumping blood throughout the body. The sinoatrial node in the heart sets the rhythm and frequency of the contractions—much like a conductor directing an orchestra.
The sinus node operates using electrical impulses. Signals are distributed throughout the entire heart via a conduction system. The electrical voltage can be measured on the skin—and it is precisely this fact that medicine utilizes in an ECG examination.
Two to six electrodes measure the changes in voltage on the skin’s surface and transmit them to the ECG machine. The machine amplifies the signals and displays them as a waveform. The doctor interprets these waveforms and draws conclusions about heart function.
The waveform is printed out or displayed on a monitor for evaluation. Both versions are also referred to as an ECG, or electrocardiogram.
Heart activity as a line on an ECG © jimmyan8511 | AdobeStock
Medicine distinguishes between three different types of ECG tests, which are used depending on the clinical question:
An ECG therefore provides different information depending on its application. On the one hand, it provides general information about heart activity at rest. Furthermore, it shows how the heart muscle reacts to physical activity and how well it adapts to stress.
The long-term ECG provides the doctor with clues about possible arrhythmias throughout the patient’s day.
Many doctors’ offices schedule appointments for long-term ECG monitoring for the early morning. The ECG device consists of
The doctor attaches the electrodes to the patient’s upper body and the cuff to the patient’s left upper arm. Then the doctor turns on the recorder.
Wiring for a long-term ECG © Andreas Koch | AdobeStock
At regular intervals—at least once an hour—the device measures blood pressure. The heart’s electrical activity is continuously recorded. The patient also keeps a log of their daily activities.
This allows the doctor to subsequently correlate any irregularities in heart activity with specific activities or times of day.
The test is designed to measure heart activity during the patient’s daily routine. The diagnosis is therefore only reliable if the patient does everything they normally do in their daily life. This includes exercise.
A long-term ECG is a useful test.
Some patients feel uncomfortable when audible noises occur during the recording, such as at the workplace. However, this circumstance should in no way prevent the test from being performed.
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