The optimal lead insertion depth for esophageal ECG recordings with respect to atrial signal quality

J Electrocardiol. 2013 Mar-Apr;46(2):158-65. doi: 10.1016/j.jelectrocard.2012.12.004. Epub 2013 Jan 8.

Abstract

Background: Diagnosing supraventricular arrhythmias by conventional long-term ECG can be cumbersome because of poor p-waves. Esophageal long-term electrocardiography (eECG) has an excellent sensitivity for atrial signals and may overcome this limitation. However, the optimal lead insertion depth (OLID) is not known.

Methods: We registered eECGs at different lead insertion depths in 27 patients and analyzed 199,716 atrial complexes with respect to signal amplitude and slope. Correlation and regression analyses were used to find a criterion for OLID.

Results: Atrial signal amplitudes and slopes significantly depend on lead insertion depth. OLID correlates with body height (rSpearman=0.71) and can be estimated by OLID [cm]=0.25*body height[cm]-7cm. At this insertion depth, we recorded the largest esophageal atrial signal amplitudes (1.27±0.86mV), which were much larger compared to conventional surface lead II (0.19±0.10mV, p<0.0001).

Conclusion: The OLID depends on body height and can be calculated by a simple regression formula.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Atrial Fibrillation / diagnosis*
  • Electrocardiography / instrumentation*
  • Electrocardiography / methods*
  • Electrodes, Implanted*
  • Esophagus / surgery*
  • Female
  • Humans
  • Male
  • Prosthesis Implantation / methods
  • Reproducibility of Results
  • Sensitivity and Specificity