Evaluation of electrocardiographic leads for detection of atrial activity (p wave) in ambulatory ECG monitoring

A pilot study

L. R. Herzog, F. I. Marcus, W. A. Scott, L. H. Faitelson, Peter - Ott, E. Hahn

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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 suprasternal 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 V1 (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 nonstandard 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.

Original languageEnglish (US)
Pages (from-to)131-134
Number of pages4
JournalPACE - Pacing and Clinical Electrophysiology
Volume15
Issue number2
StatePublished - 1992

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Ambulatory Monitoring
Electrocardiography
Xiphoid Bone
Cardiac Arrhythmias
Lead

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Evaluation of electrocardiographic leads for detection of atrial activity (p wave) in ambulatory ECG monitoring : A pilot study. / Herzog, L. R.; Marcus, F. I.; Scott, W. A.; Faitelson, L. H.; Ott, Peter -; Hahn, E.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 15, No. 2, 1992, p. 131-134.

Research output: Contribution to journalArticle

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AU - Hahn, E.

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