Conduction system of the Heart

Your heart has an electrical system that controls the speed and pattern of your heart beat. A normal “sinus rhythm” starts from the Sinoatrial (SA) node and spreads down to the Atrioventricular (AV) node as the atria contract and force blood into the ventricles. The ventricles then contract and pump blood out of the heart as electrical signals reach the ventricular muscle cells.


An ECG (Electrocardiogram) is a simple, non-invasive and painless recording of the electrical activity of your heart on a graph paper.

What can an ECG detect?

Video on various heart rhythms

  • Arrhythmias – Abnormal heart rhythms resulting in irregular heart beats or palpitations
  • Cardiac ischemia – Heart artery blockages resulting in poor blood flow to the heart muscle
  • Acute myocardial infarction – Ongoing heart attack
  • Old myocardial infarction – Previous damage to the heart muscle
  • Dilated cardiomyopathy – Structural abnormalities of the heart such as heart chamber enlargement
  • Ventricular hypertrophy – Thickened heart muscles due to high blood pressure
  • Pericarditis – Inflammation of the sac that surrounds the heart
  • How well a current heart disease treatment (eg. pacemaker device) is working

Who will benefit from this test?

Patients with symptoms of

  • Chest pain
  • Shortness of breath
  • Irregular heart beats
  • Recurrent giddiness or fainting spells
  • Patients planning to participate in strenuous sporting activities
  • Patients with a family history of sudden cardiac death
  • As part of Heart Screening

How to prepare for the test

  • Wear a shirt that can be easily removed so as to facilitate placement of electrodes on the chest
  • Avoid full-length hosiery as electrodes will be placed directly on your legs
  • Avoid any emollients or lotions on the day of the test as they interfere with the electrode-skin contact
  • Inform our doctor if you are on any medications or supplements as they may affect the outcome of your ECG

How is the test performed?

  • You will be asked to lie down on a couch and a cardiac technician will attach 10 electrodes with adhesive pads to the skin on your chest, arms and legs. Men may need their chest hair shaved to allow a better connection
  • The ECG machine will create a picture on a graph paper of the electrical impulses that travel through your heart
  • Your ECG pattern will be reviewed by our doctor and kept on file for comparisons with future ECG recordings
  • The whole process typically takes only a few minutes and is painless

More Information

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