Abstract The details of digital recording and computer processing of a 12-lead electrocardiogram (ECG) remain a source of confusion for many health care professionals. A better understanding of the design and performance tradeoffs inherent in the electrocardiograph design might lead to better quality in ECG recording and better interpretation in ECG reading. This paper serves as a tutorial from an engineering point of view to those who are new to the field of ECG and to those clinicians who want to gain a better understanding of the engineering tradeoffs involved. The problem arises when the benefit of various electrocardiograph features is widely understood while the cost or the tradeoffs ...