ECG Paper

ECG paper is specialized graph paper used by an electrocardiograph machine to record and display the heart’s electrical activity. It’s crucial for diagnosing and monitoring various heart conditions like arrhythmias, heart attacks, and cardiomyopathies.

Key features

• Grid: The paper features a precisely calibrated grid system:
  • Small squares (1mm x 1mm): Each small square horizontally represents 0.04 seconds (40 milliseconds) of time and vertically represents 0.1 mV of electrical activity.
  • Large squares (5mm x 5mm): These are made up of 5 small squares and represent 0.20 seconds (200 milliseconds) horizontally and 0.5 mV vertically.
  • Heavier lines often demarcate the large squares for easy identification.
• Horizontal axis (Time): Measures time, with the standard paper speed set at 25 mm/second. This means each small square corresponds to 0.04 seconds, and each large square to 0.20 seconds.
• Vertical axis (Voltage/Amplitude): Measures the strength (amplitude) of the electrical signals in millivolts (mV). The standard calibration is 10 mm (10 small squares) for 1 mV, but it can be adjusted depending on the waveform size.
• Thermal-sensitive paper: ECG paper is usually thermal-sensitive, meaning the recording stylus uses heat to create a dark tracing as the paper moves through various machines.

Purpose and significance

• ECG paper acts as a visual record of the heart’s electrical impulses, enabling healthcare professionals to assess the heart rate, rhythm, and any abnormalities.
• It facilitates the identification of various heart conditions and helps in monitoring the effects of medications or treatments on the heart’s electrical activity.
• Despite advancements in digital technologies, ECG paper remains widely used due to reasons like clinician comfort, reliable backup in case of system failures, ease of sharing, fulfilling legal requirements, and compliance with regulations.

In essence, ECG paper is a fundamental tool in cardiology, providing a tangible and interpretable representation of the heart’s electrical activity for accurate diagnosis, treatment, and ongoing monitoring.