From the Guidelines
You should consult a qualified healthcare provider for accurate ECG interpretation, as it requires specialized medical training and expertise. ECG interpretation involves examining the electrical activity of the heart to identify normal patterns and abnormalities, which is a complex task that requires knowledge of various components including heart rate, rhythm, intervals (PR, QRS, QT), axis, and specific waveform patterns 1. According to the American College of Physicians, interpretation of ECGs varies greatly, even among expert electrocardiographers, and noncardiologists seem to be more influenced by patient history in interpreting ECGs than are cardiologists 1.
Some key points to consider when it comes to ECG interpretation include:
- The importance of specialized training, such as residency training in internal medicine with Advanced Cardiac Life Support instruction, for bedside interpretation of resting 12-lead ECGs in routine and emergency situations 1
- The potential benefits of computer-assisted ECG interpretation in reducing errors, but also the need for these tools to be used as an adjunct to, not a replacement for, trained provider interpretation 1
- The need for ongoing competency assessment and maintenance to ensure accurate ECG interpretation skills 1
Given the complexity and potential for error in ECG interpretation, it is crucial to seek the expertise of a qualified healthcare provider who can examine the tracing in the context of your clinical situation and medical history, rather than attempting self-interpretation without proper training.
From the Research
ECG Interpretation
- The accuracy of physicians' ECG interpretations varies widely across studies, with a median accuracy of 54% for pretraining assessments and 67% for posttraining assessments 2.
- Physicians at all training levels have deficiencies in ECG interpretation, even after educational interventions, highlighting the need for improved education 2.
- Cardiologists frequently disagree with computer-interpreted normal ECGs, with 6.1% of cases being potentially clinically significant 3.
ECG Diagnosis and Risk Stratification
- The ECG remains an essential tool for diagnosing, risk stratifying, and guiding reperfusion and invasive strategies in patients with suspected acute coronary syndromes 4.
- ECG reading can be demanding, with many healthcare professionals lacking the necessary expertise to accurately interpret them 4.
- The ECG diagnosis of ST-elevation myocardial infarction (STEMI) is sometimes challenging, and discerning it from non-ST-elevation myocardial infarction (NSTEMI) is of paramount importance to implement timely acute reperfusion therapy 4.
ECG Quality and Clinical Interpretations
- A novel pre-positioned electrode system has been shown to be equivalent to conventional individual electrodes in terms of ECG quality and clinical interpretations 5.
- The use of pre-positioned electrodes can simplify and reduce technical errors, such as limb leads reversal and inaccurate chest leads placement, for 12-lead ECG tests 5.
Artificial Intelligence-Enhanced ECG
- Artificial intelligence (AI) can be applied to the ECG to enable rapid, human-like interpretation and detect signals and patterns largely unrecognizable to human interpreters 6.
- AI models can be developed for the detection of left ventricular dysfunction, silent atrial fibrillation, and hypertrophic cardiomyopathy, as well as the determination of a person's age, sex, and race, among other phenotypes 6.