TY - JOUR
T1 - Evaluation of Electrocardiographic Leads for Detection of Atrial Activity (P Wave) in Ambulatory EGG Monitoring
T2 - A Pilot Study
AU - Herzog, L. R.
AU - Marcus, F. I.
AU - Scott, W. A.
AU - Faitelson, L. H.
AU - Ott, P.
AU - Hahn, E.
PY - 1992/2
Y1 - 1992/2
N2 - The usual lead systems for ambulatory ECG monitoring (AECG) used in the evaluation of arrhythmias is a modified bipolar V‐1 and V‐5. A comparison of various lead systems to enhance the detection of atrial activity (p waves) has not been reported. We evaluated various surface lead systems in 12 subjects comparing p waves recorded at 20 mm/mV and 50 mm/sec. We compared p wave area, amplitude, and duration from modified bipolar V1 and V5 as well as seven nonstandard leads recorded on a AECG monitor. Of the seven nonstandard leads, a vertical sternal lead, with the negative pole just below the suprasfernal notch and the positive pole at the xiphoid process, had the largest area (1.46 ± 0.65 mm2), and also had a greater area than the standard V, (0.88 ± 0.45 mm) and V5, (1.06 ± 0.49 mm2) lead system (P < 0.01). We conclude that the bipolar vertical sternal lead system provides a larger p wave area than seven nonsfandard bipolar lead systems and the two standard lead systems currently used in AECG monitoring. Replacement of the modified bipolar V1 lead with a vertical sternal lead should improve the recognition of atrial activity and, therefore, enhance the diagnosis of cardiac arrhythmias.
AB - The usual lead systems for ambulatory ECG monitoring (AECG) used in the evaluation of arrhythmias is a modified bipolar V‐1 and V‐5. A comparison of various lead systems to enhance the detection of atrial activity (p waves) has not been reported. We evaluated various surface lead systems in 12 subjects comparing p waves recorded at 20 mm/mV and 50 mm/sec. We compared p wave area, amplitude, and duration from modified bipolar V1 and V5 as well as seven nonstandard leads recorded on a AECG monitor. Of the seven nonstandard leads, a vertical sternal lead, with the negative pole just below the suprasfernal notch and the positive pole at the xiphoid process, had the largest area (1.46 ± 0.65 mm2), and also had a greater area than the standard V, (0.88 ± 0.45 mm) and V5, (1.06 ± 0.49 mm2) lead system (P < 0.01). We conclude that the bipolar vertical sternal lead system provides a larger p wave area than seven nonsfandard bipolar lead systems and the two standard lead systems currently used in AECG monitoring. Replacement of the modified bipolar V1 lead with a vertical sternal lead should improve the recognition of atrial activity and, therefore, enhance the diagnosis of cardiac arrhythmias.
KW - ambulatory ECG monitoring
KW - cardiac arrhythmias
KW - monitoring lead systems
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U2 - 10.1111/j.1540-8159.1992.tb03055.x
DO - 10.1111/j.1540-8159.1992.tb03055.x
M3 - Article
C2 - 1372410
AN - SCOPUS:0026506284
SN - 0147-8389
VL - 15
SP - 131
EP - 134
JO - Pacing and Clinical Electrophysiology
JF - Pacing and Clinical Electrophysiology
IS - 2
ER -