Exercise Physiology Institute

Resting ECG

What is Resting ECG?

A resting electrocardiogram (ECG or EKG) is a non-invasive test that records the electrical activity of the heart while the patient is at rest. It involves placing electrodes on the skin of the chest, arms, and legs to detect and record the electrical impulses generated by the heart as it beats.

Why is Measuring Resting ECG Important?

Resting ECGs are used for assessing cardiac health and identifying abnormalities such as arrhythmias, conduction disorders, and signs of reduced blood flow to the heart. They are routinely used for screening purposes, especially in individuals with risk factors for heart disease, such as hypertension, diabetes, or a family history of cardiac issues. Exercise Physiologist’s use resting ECG’s to screen for relative and absolute contradictions to exercise.

Example Communication with the Client when Measuring Resting ECG

Today we will be completing a resting ECG which is an non invasive test however it will require me to place these sticky electrodes with leads attached on your chest, wrists and ankles so we can see the electrical activity of your heart whilst lying here on this bed. You will need to remove your shirt for this assessment. Are you comfortable doing this? Before I place the electrodes on to your skin, I need to clean the area using this alcohol swab. I may also need to shave the area. Are you ok if I begin?

If you could please remove your shirt and lie down on your back on the bed. I am first going to use this alcohol swab to wipe the insides of your wrist and ankle and then six locations on your chest. Now I am going to attach these electrodes and corresponding leads. To begin the test I am going to ask you to relax and try not to move for the next couple of minutes. Whilst you are relaxing I will analyze your heart’s electrical activity and record the data.

Great, thank you for remaining still and calm. The test is complete. I will now remove the leads and electrodes and clean any sticky residue off your skin. You may put your shirt back on and I will go through your results with you now.

What was the Result and How Does it Compare to Normative Data?

From your resting ECG today I can see that your heart beat is 67 bpm which places you in the normal category. You are in normal sinus rhythm and have no signs of arrythmias. All of the parameters that I have measured are in the normal category placing you at a low risk of coronary artery disease. Whist this is positive news, it is only a snap shot of your heart’s activity at rest today. We will continue to monitor your cardiovascular function via heart rate and blood pressure readings during our session. To maintain a healthy cardiovascular system we would like you to aim to complete at least 30 mins of moderate to vigorous exercise on five days a week, eat a nutritious and varied diet and refrain from smoking and excessive alcohol consumption. All of which we can discuss in more detail later in the assessment/sessions.

Example for results outside of the normal category:

From your resting ECG today I can see that your heart beat is 67 bpm which places you in the normal category. You are in a normal sinus rhythm and the majority of the parameters I measured today place you in the normal category. I can see that a section on the trace called your ST segment is sloping downwards. This may indicate ischemia or narrowing of your arteries due to cholesterol plaque build up. Have you been told you have any cardiovascular concerns in the past? Have you ever been told you have high cholesterol? This is only a snap shot of your heart’s activity at rest today and not used for diagnostic purposes. I suggest visiting your preferred medical practitioner to discuss this result further and I will provide you with a print out of your results. We will continue to monitor your cardiovascular function via heart rate and blood pressure readings during our session. To maintain a healthy cardiovascular system we would like you to aim to complete at least 30 mins of moderate to vigorous exercise on five days a week, eat a nutritious and varied diet and refrain from smoking and excessive alcohol consumption. All of which we can discuss in more detail later in the assessment/sessions.

ECG Tips

When measuring a resting electrocardiogram (ECG), several key points should be considered to ensure accurate and reliable results:

  1. Patient Preparation: Ensure the patient is in a relaxed and comfortable position, lying flat on their back, with minimal movement and muscle tension. Remove any clothing or jewelry that may interfere with electrode placement.
  2. Proper Electrode Placement: Place the ECG electrodes correctly on the patient’s chest, wrists, and ankles according to the standard lead positions. Ensure good skin contact and adequate electrode adherence and avoid tangling and crossing the leads to minimize artifact and ensure accurate signal acquisition.
  3. Electrode Skin Preparation: Clean and prepare the skin at the electrode sites to remove oils, lotions, or sweat, which can interfere with electrode contact and signal quality. If necessary, shave excessive hair to improve electrode adherence.
  4. Patient Education and Comfort: Inform the patient about the procedure and reassure them about its non-invasive nature. Encourage relaxation and comfort throughout the ECG recording to minimize muscle artifacts and ensure an accurate resting state.
  5. Monitor and Verify Signal Quality: Continuously monitor the ECG signal during recording to identify and correct any artifacts or technical issues promptly. Verify that the recorded waveform is clear, with distinct P waves, QRS complexes, and T waves, indicating proper signal acquisition.
  6. Recording Duration: Record the resting ECG for a sufficient duration to capture multiple cardiac cycles and assess heart rhythm variability accurately. Typically, a recording duration of 5 to 10 minutes is recommended to ensure comprehensive evaluation.

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