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Electrocardiography (ECG)

An electrocardiography test (ECG or an EKG) records the electrical activity of your heart and can detect rhythm associated with heart disease. It is completed by placing stickers (called electrodes) on the patient’s chest, which can then record the electrical activity that occurs as the heart beats.

Your doctor uses the ECG to:

  • Assess your heart rhythm.
  • Diagnose poor blood flow to the heart muscle “ischemia”.
  • Diagnose a heart attack.
  • Diagnose abnormalities of your heart, such as heart chamber enlargement or detect electrical abnormalities commonly known as “arrhythmia” that patients sometimes may or may not feel.

To prepare:

  • Avoid oily or greasy skin creams and lotions the day of the test, as the cream can interfere with the sticker-skin contact.

What to wear:

  • Wear a shirt that can be easily removed to place the leads on the chest.

What to expect:

  • During a resting ECG, a technician will attach 12 stickers with adhesive pads to your chest, arms and legs. Men may have chest hair shaved to allow a better connection.
  • You will lie flat while the computer creates a picture, on graph paper, of the electrical impulses traveling through your heart.
  • It takes about 5 minutes to attach the electrodes and complete the test, but the actual recording takes only a few seconds.
  • Your ECG patterns will be kept on file for comparison with future ECG recordings.

After the procedure: 

  • People can resume their normal daily activities, including driving, after an ECG.
  • Your ECG will be reviewed and the results will be reported to your doctor. If necessary you may be referred for additional testing or a consultation with a physician.

Exercise Stress Testing

An exercise stress test, sometimes also known as a treadmill test, or stress test, allows us to monitor how your heart responds to exercise on our specialized medical treadmill. Stickers are placed on the chest to capture your heart rhythm. The incline of the treadmill and speed will slowly increase in short intervals as a cardiac technologist monitors the electrical activity of your heart as you walk and run on the treadmill. The test will be completed when you reach your target heart rate, or sooner in the event that you tell the technologist that you wish to stop.

Your doctor uses the exercise stress test to:

  • See how well your heart responds to the different levels of exercise.
  • Determine the appropriate level of exercise for you, as well as determine whether there is a blood flow reduction in the arteries supplying the heart.
  • Detect abnormal heart rhythms (arrhythmias) and diagnose the presence or absence of coronary artery disease.

To prepare: 

  • Avoid oily or greasy skin creams and lotions the day of the test, as the cream can interfere with the electrode-skin contact.
  • Take your usual medications unless otherwise directed by your physician.

What to wear: 

  • Wear comfortable clothes and shoes that are suitable for walking on a treadmill, and bring a water bottle.

What to expect: 

  • A technologist will explain the test to you, take a brief medical history, and answer any questions you may have. Your blood pressure, heart rate, and electrocardiogram (ECG) will be monitored before, during, and after the test.
  • You will be asked to remove all upper body clothing, and to put on a gown with the opening to the front.
  • Adhesive stickers called electrodes will be put onto your chest to capture an ECG. The sites where the electrodes are placed will be cleaned with alcohol and shaved if necessary. A mild abrasion may also be used to ensure a good quality ECG recording.
  • You will be asked to walk on a treadmill. The walk starts off slowly, then the speed and incline increases at set times. Inform the technologist how you are feeling during the test. The technician will monitor your heart and let you know when the test is completed.
  • Following the test, your blood pressure, heart rate, and ECG will be monitored for three to five minutes after exercise.
  • The test takes about 30 minutes to complete.
  • The data will be reviewed by a cardiologist after the test is completed. A report will be sent to the doctor(s) involved in your care.

After the procedure: 

  • People can resume their normal daily activities, including driving, after an exercise stress test.


An echocardiogram (ECHO) uses ultrasound to capture images of your heart while it beats. This is the same non-invasive ultrasound technology used to check the health of a baby during pregnancy. An echocardiogram is used to assess the anatomical function of your heart; valves, chambers, size and shape of the heart, pumping capacity, how the heart relaxes, blood flow in the heart (Eg. leaky valves) location and extent of cardiac disease.

Your doctor uses the ECHOCARDIOGRAM to:

  • Check for problems with the valves or chambers of your heart.
  • Determine if heart problems are the cause of symptoms such as shortness of breath or chest pain.
  • Detect other heart diseases.
  • Help with cardiac management and follow up management of patients with any suspected or known heart diseases.

To prepare:

  • No special preparation is required. You can eat, drink and take medications as you normally would.

What to wear:

  • Wear a loose fitting shirt. The sonographer will provide you with a gown to change into.

What to expect:

  • You’ll undress from the waist up and lie down on an examination bed.
  • The technician (sonographer) will attach stickers (called electrodes) to your chest to record your heart rhythm. Gel will be applied to your chest to capture the images using a device called a transducer. The transducer emits and records the returning sound waves. A computer converts the returning sound wave (echos) into detailed moving images of your heart. These are the images that are viewed by the doctor that reads your echocardiogram.
  • You may feel some discomfort from the transducer against your chest as the sonographer may need to apply some mild pressure to obtain the best images of your heart.
  • The sonographer may guide you to breath in and out at certain times and may ask you to roll onto your left side.
  • It takes about 45 minutes to complete the test.
  • Your echocardiography will be kept on file for comparison with future echocardiography tests.

After the procedure:

  • People can resume their normal daily activities, including driving, after an echocardiogram.
  • Your echocardiogram will be reviewed and the results will be reported to your doctor. If necessary, you may be referred for additional testing or a consultation with a physician.

Stress Echocardiography

A stress echocardiography test, or sometimes known as a “stress echo”, is a combination of a stress test along with an echocardiogram of your heart. Its main purpose is to assess the wall motion of your heart in response to physical stress (on the treadmill). Stress echocardiography is also non-invasive.

24h/48h/72h/14 day Holters

A holter is a portable device that records data on your electrical cardiac activity over a period of 24, 48, 72 hours, or 14 days. This test allows your physicians to capture more data on your cardiac activity over a longer period of time compared to a single echocardiogram test session.

Contrast Echo

Contrast Stress Echo

Pediatric Cardiac Tests

PACE is pleased to offer pediatric cardiac testing at various locations. At our Barrie and Newmarket clinics, we offer pediatric ECHO, ECG, and Holter Monitor testing. In Orillia, we offer pediatric ECHOs. For a full description of these cardiac tests, please see above. Note: please allow extra time for pediatric testing. All tests are read by a pediatric cardiologist.

Bubble Study

Ambulatory Blood Pressure Monitor

A portable blood pressure unit worn to monitor and record your blood pressure every 20 – 30 mins for a 24 hour continuous period of wear. *Note: this is a $50 non OHIP-covered service

Type 2 Diabetes Clinic

PACE Barrie is pleased to announce the opening of a Type 2 Diabetes/Cardio-Metabolic Clinic. The primary focus of the clinic is the management of Type 2 Diabetes in patients with documented vascular disease to improve glycemic control and reduce further cardiac complications. To make an appointment, please call 705-721-4422 or fax your referral to 1-705-721-5577.


PACE is please to offer OTN (Telemedicine) appointments. Telemedicine uses telecommunications technology to provide clinical health care in Ontario at a distance. These appointments are for patients who have difficulties with transportation, live far away, or just need a quick follow up. For more information or to set up an OTN appointment with a PACE cardiologist, please call 1-888-662-0680.


With the recent opening of the Royal Victoria Regional Health Centre’s expanded cardiac program, please be advised that Barrie now offers basic pacemaker implantation. All complex device implantation (ICDs, leadless, left bundle branch and His bundle pacing, as well as bi-ventricular / cardiac resynchronization therapy) will continue to be offered exclusively at Southlake, along with basic pacemaker implantation. The Southlake Heart Rhythm Program will continue to manage all pacemaker referrals through the Triage office and will distribute some of the referrals made out to Southlake to RVH. For physicians specifically wishing to refer patients for non-emergent device implantation by the Southlake Electrophysiology Team (Drs. Yaariv Khaykin, Atul Verma, Alfredo Pantano and Bernice Tsang), please send these referrals directly to PACE Cardiology (fax 1-855-239-1623).