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It is indispensable for the diagnosis and prompt initiation of therapy in patients with acute coronary syndromes and is the most accurate means of diagnosing intraventricular conduction disturbances and arrhythmias.

Its interpretation may lead to the recognition of electrolyte abnormalities, particularly of serum potassium and calcium, and permit the detection of some forms of genetically mediated electrical or structural cardiac abnormalities.

Additional articles, to be published subsequently, will discuss the ECG interpretation of intraventricular conduction disturbances, abnormalities of ventricular repolarization, hypertrophy, and ischemia/infarction.

The purposes of this statement are (1) to examine the relation of the resting ECG to its technology, (2) to increase understanding of how the modern ECG is derived and recorded, and (3) to promote standards that will improve the accuracy and usefulness of the ECG in practice.

The project has been endorsed by the American College of Cardiology, the Heart Rhythm Society, and the International Society for Computerized Electrocardiology. G.) was selected by the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology of the AHA.

The purposes of this project are as follows: (1) to review the status of techniques currently used to record and interpret the ECG and to identify opportunities for modification; (2) to simplify and unify the various descriptive, diagnostic, and modifying terminologies currently used in order to create a common and more easily applied lexicon; and (3) to identify the weaknesses of the descriptive, interpretative, and comparative algorithms and recommend changes that incorporate the newly recognized factors referred to above. He formed an advisory group to assist in setting goals and to recommend other writing group members.

Since 1978, there have been many advances in the technology of electrocardiography; in the understanding of the anatomic, pathological, electrophysiological, and genetic information underlying ECG findings; and in the clinical correlations of ECG abnormalities.Sensitivity and specificity of computer-based diagnostic statements are improving, but at the same time, it remains evident that physician overreading and confirmation of computer-based ECGs is required.A number of recommendations for the standardization of ECG recording and guidelines for ECG interpretation in the computer era have appeared during the past several decades.Derivation of representative waveforms and measurements based on global intervals are described.Special emphasis is placed on digital signal acquisition and computer-based signal processing, which provide automated measurements that lead to computer-generated diagnostic statements.




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