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

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• 作者：Andreas Haeberlin ; MD^a ; ^b ; Thomas Niederhauser ; MSc^a ; ^c ; Thanks Marisa ; MSc^c ; Josef Goette ; PhD^c ; Marcel Jacoment ; PhD^c ; Daniel Mattle ; MD^d ; Laurent Roten ; MD^b ; Juerg Fuhrer ; MD^b ; Hildegard Tanner ; MD^b ; Rolf Vogel ; MD ; PhD^a ; ^e ; ^{rolf.vogel@spital.so.ch}
• 关键词：Esophageal long-term electrocardiography ; Optimal lead insertion depth ; Body height
• 刊名：Journal of Electrocardiology
• 出版年：2013
• 出版时间：March-April, 2013
• 年：2013
• 卷：46
• 期：2
• 页码：158-165
• 全文大小：444 K

文摘

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 (r_Spearman = 0.71) and can be estimated by OLID [cm] = 0.25*body height[cm] ? 7 cm. At this insertion depth, we recorded the largest esophageal atrial signal amplitudes (1.27 ¡À 0.86 mV), which were much larger compared to conventional surface lead II (0.19 ¡À 0.10 mV, p < 0.0001).

Conclusion

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