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Electrocardiogram

Electrocardiogram

An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...

Electrocardiogram Fundamentals

Electrocardiogram Fundamentals

Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin to...

Cardiac Action Potential

Cardiac Action Potential

Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...

Pulse rhythm

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...

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Dynamic Expression Of The Type 1 Brugada Ecg Pattern During Tilt Table Testing Using Continuous High Precordial Lead Positioning.

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Dynamic Expression Of The Type 1 Brugada Ecg Pattern During Tilt Table Testing Using Continuous High Precordial Lead Positioning.

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Dynamic Expression of the Type 1 Brugada ECG Pattern During Tilt Table Testing Using Continuous High Precordial Lead

Eduardo Nolla Silva Pereira¹, Luciana Sacilotto¹, Tan Chen Wu¹

¹Cardiac Arrhythmias Unit, Instituto do Coração-InCor-HCFMUSP, Faculdade de Medicina, Hospital das Clínicas da Universidade de São Paulo, São Paulo 05403-900, Brazil.

Diagnostics (Basel, Switzerland)

|June 12, 2026

View abstract on PubMed

Summary

This summary is machine-generated.

Tilt table testing with high-precordial leads does not unmask the Brugada ECG pattern (BrP1). Persistent BrP1 during testing may indicate higher syncope risk in Brugada syndrome patients.

Keywords:

Brugada syndrome Brugada type-1 ECG pattern autonomic modulation high precordial leads tilt table test

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Area of Science:

Cardiology
Electrophysiology
Autonomic Nervous System

Background:

The Type 1 Brugada ECG pattern (BrP1) is influenced by autonomic activity.
Tilt table testing alters autonomic function, potentially affecting BrP1 expression.
The clinical significance of BrP1 variability during tilt testing is unclear.

Purpose of the Study:

To investigate the dynamic behavior of BrP1 during tilt table testing in Brugada syndrome patients.
To assess the association between dynamic BrP1 expression and clinical characteristics.
To determine if tilt table testing can serve as a diagnostic tool for BrP1.

Main Methods:

Cross-sectional study of 44 Brugada syndrome patients undergoing tilt table testing.
Continuous ECG monitoring with high-precordial leads during supine, tilt, nitrate, recovery, and syncope phases.

Analysis of BrP1 expression variability and correlation with clinical data.

Main Results:

BrP1 expression varied dynamically during tilt table testing.
No new BrP1 was unmasked during tilt.
Persistent BrP1 was associated with increased syncope and ICD implantation (p < 0.05).

Conclusions:

Tilt table testing with high-precordial leads is not a diagnostic provocation tool for BrP1.
The test can characterize autonomic modulation and phenotypic stability in Brugada syndrome.
Prognostic value of dynamic BrP1 requires further prospective research.