Precordial electrode placement for optimal ECG monitoring: implications for ambulatory monitor devices and event recorders.

摘要: Introduction Detection of QRS complexes, P-waves and atrial fibrillation f-waves in electrocardiographic (ECG) signals is critical for the correct diagnosis arrhythmias. We aimed to find best bipolar lead (BL) with highest signal amplitude shortest inter-electrode spacing. Methods ECG (120 seconds) were recorded 36 patients 16 precordial electrodes placed a standardized pattern. An average was analysed each 120 possible BLs obtained by calculating difference between pairs unipolar leads. Peak-to-peak amplitudes waves (50 ms around R-peak) P (270–70 ms before calculated. For fibrillation, power fibrillatory (f) wave used instead. Maximum values at distance considered differentiation analysis performed based on incremental changes (amplitude distance). Results There significant correlation QRS-amplitude (r = 0.78, p < 0.001), P-wave (r = 0.60, p < 0.01) f-wave (r = 0.79, p < 0.001). The range was: 0.7–2.33 mV, 0.07–0.18 mV, 0.55–2.12 mV2/s. maximum value heart-aligned axis over left ventricle complex (1.9 mV 8.7 cm) atria (0.98 mV) (1.45 mV2/s 8 cm, respectively). Conclusion There strong positive electrode ECG signal-amplitude. Distance 8 cm relevant heart-chamber provides distance. These findings are essential design use ambulatory monitoring devices.