Tune in to rhythm

The invention of the electrocardiograph (ECG) in 1902 was a major advance in cardiac diagnosis. It was immediately apparent that the ECG provides uniquely important information on cardiac rhythm, and it was soon recognised that it may also reveal myocardial ischaemia and infarction, as well as structural heart disease. Once the defining skill of a cardiologist, an ability to interpret the ECG is now expected of all doctors and an increasing number of nurses.

But how do you acquire this ability? The ECG is in effect a picture, and its interpretation largely depends on pattern recognition combined with diagnostic logic. The beginner needs to have a conceptual framework on which interpretation is based; progress comes with practice and feedback.

This introductory text adopts the standard systematic approach to the analysis of the ECG. Chapters deal in turn with the basic science, heart rate and rhythm, and individual waves and segments. Additional topics such as pacemakers and exercise ECG testing are also covered (although the ECG in the assessment of acute chest pain is not, which, given its importance, is surprising). Material for self-testing is not included, but this can be found readily elsewhere. The pages are enlivened by clear figures and text boxes with words of wisdom (sometimes perhaps too obvious to justify their prominence). The book is slim enough to fit easily in a white coat pocket and has a wipe-clean cover.

Its major strength is its lucid and comprehensive overview of ECG analysis, combined with plenty of information on the relevance of the findings. Clearly it is a matter of judgement as to how much clinical information should be included, and there is inevitably an overlap between this book and cardiology texts. However, I see this as an advantage and will recommend the book to trainees.

David Sprigings is consultant cardiologist, Northampton General Hospital.