Improved recording of atrial activity by modified bipolar leads derived from the 12-lead electrocardiogram

Alan Kennedy; Dewar D Finlay; Daniel Guldenring; Raymond R Bond; David J McEneaney; Aaron Peace; James McLaughlin

doi:10.1016/j.jelectrocard.2015.08.025

Improved recording of atrial activity by modified bipolar leads derived from the 12-lead electrocardiogram

J Electrocardiol. 2015 Nov-Dec;48(6):1017-21. doi: 10.1016/j.jelectrocard.2015.08.025. Epub 2015 Aug 20.

Authors

Alan Kennedy¹, Dewar D Finlay², Daniel Guldenring², Raymond R Bond³, David J McEneaney⁴, Aaron Peace⁵, James McLaughlin²

Affiliations

¹ Nanotechnology and Integrated BioEngineering Centre, University of Ulster, Northern Ireland, UK. Electronic address: Kennedy-a23@email.ulster.ac.uk.
² Nanotechnology and Integrated BioEngineering Centre, University of Ulster, Northern Ireland, UK.
³ Computer Science Research Institute, University of Ulster, Northern Ireland, UK.
⁴ Craigavon Cardiac Center, Craigavon Area Hospital, Northern Ireland, UK.
⁵ Altnagelvin Hospital, Northern Ireland, UK.

PMID: 26410197
DOI: 10.1016/j.jelectrocard.2015.08.025

Abstract

This study investigates the use of multivariate linear regression to estimate three bipolar ECG leads from the 12-lead ECG in order to improve P-wave signal strength. The study population consisted of body surface potential maps recorded from 229 healthy subjects. P-waves were then isolated and population based transformation weights developed. A derived P-lead (measured between the right sternoclavicular joint and midway along the costal margin in line with the seventh intercostal space) demonstrated significant improvement in median P-wave root mean square (RMS) signal strength when compared to lead II (94μV vs. 76μV, p<0.001). A derived ES lead (from the EASI lead system) also showed small but significant improvement in median P-wave RMS (79μV vs. 76μV, p=0.0054). Finally, a derived modified Lewis lead did not improve median P-wave RMS when compared to lead II. However, this derived lead improved atrioventricular RMS ratio. P-wave leads derived from the 12-lead ECG can improve signal-to-noise ratio of the P-wave; this may improve the performance of detection algorithms that rely on P-wave analysis.

Keywords: 12-Lead electrocardiogram; Atrial activity; Derived leads; P-wave.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Algorithms*
Atrial Fibrillation / diagnosis*
Body Surface Potential Mapping / instrumentation*
Body Surface Potential Mapping / methods*
Diagnosis, Computer-Assisted / methods*
Equipment Design
Equipment Failure Analysis
Humans
Reproducibility of Results
Sensitivity and Specificity