NDLI: Detecting the Elusive P-Wave: A New ECG Lead to Improve the Recording of Atrial Activity

Content Provider	IEEE Xplore Digital Library
Author	Kennedy, A. Finlay, D.D. Guldenring, D. Bond, R.R. McLaughlin, J.
Copyright Year	1964
Abstract	Goal: In this study, we report on a lead selection method that was developed to detect the optimal bipolar electrode placement for recording of the P-wave. Methods: The study population consisted of 117 lead body surface potential maps recorded from 229 healthy subjects. The optimal bipolar lead was developed using the training set (172 subjects) then extracted from the testing dataset (57 subjects) and compared to other lead systems previously reported for improved recording of atrial activity. All leads were assessed in terms of P-wave, QRS, and STT root mean square (RMS). The P/QRST RMS ratio was also investigated to determine the atrioventricular RMS ratio. Finally, the effect of minor electrode misplacements on the P-lead was investigated. Results: The P-lead discovered in this study outperformed all other investigated leads in terms of P-wave RMS. The P-lead showed a significant improvement in median P-wave RMS (93 versus 72 μV, p <; 0.001) over the next best lead, Lead II. An improvement in QRS and STT RMS was also observed from the P-lead in comparison to lead II (668 versus 573 μV, p <; 0.001) and (327 versus 196 μV, p <; 0.001). Although P-wave RMS was reduced by incorrect electrode placement, significant improvement over Lead II was still evident. Conclusion: The P-lead improves P-wave RMS signal strength over all other investigated leads. Also the P-lead does not reduce QRS and STT RMS making it an appropriate choice for atrial arrhythmia monitoring. Significance: Given the improvement in signal-to-noise ratio, an improvement in algorithms that rely on P-wave analysis may be achieved.
Sponsorship	IEEE Engineering in Medicine and Biology Society
Page Count	7
File Size	790244
Starting Page	243
Ending Page	249
File Format	PDF
ISSN	00189294
Volume Number	63
Issue Number	2
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2016-01-01
Publisher Place	U.S.A.
Access Restriction	One Nation One Subscription (ONOS)
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Lead Electrocardiography Electrodes Standards Heart beat Monitoring Sociology biomedical signal processing ECG signal-to-noise ratio P-wave signal-to-noise ratio (SNR) Biomedical signal processing electrocardiogram (ECG)
Content Type	Text
Resource Type	Article
Subject	Biomedical Engineering

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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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