The ECG Signal for Echocardiography

DOPPLER TISSUE IMAGING

Optimizing the ECG Signal for Echocardiography

 

While an echocardiogram is primarily an ultrasound exam, there are other sources of information that are of critical importance to the acquisition of a useful examination.

Without a good ECG signal, an echocardiogram has considerably less potential for providing maximal diagnostic information.

  1. The complete ECG signal should be within the borders of the chart and of large enough amplification so that accurate measurements can be made at critical points in the cardiac cycle.  Ensure that the ECG signal is of sufficient gain and positioning so that the complete QRS complex and its conduction characteristics are clearly visible. The ECG baseline should not wander nor at any time leave the image. Try to eliminate muscle artifact that will make measurements more difficult.
  2. The baseline should be adjusted so that the ECG tracing (specifically, the peak of the R wave), is not cut-off at the edge of the chart. The PW Doppler Velocity should not obscure the ECG in any way.  Either move the PW Doppler baseline and adjust the scale or move the ECG baseline to a clear area of the chart.
  3. The ECG electrode positions should not be moved during the study. Make all adjustments to the ECG prior to acquiring any images. Obtain extra images for technically difficult ECG connections.
  4. Here are some examples of some common errors in Doppler recordings:

Above: ECG wanders off the chart

Above:  ECG is too small

 

Above:  Peak of the R wave is cut off making use of the analysis cursors impossible.