Introduction: Monitoring or serial 12-lead electrocardiogram (ECG) recordings are the accepted requirement for prehospital data acquisition in patients with chest pain. The purpose of this study was to determine whether waveforms and clinical triage decision are similar in EASI-derived ECGs and paramedic-acquired 12-lead ECGs using Mason-Likar limb lead configuration when compared with standard 12-lead ECGs (stdECG).
Method: Twenty patients with chest pain had a prehospital 12-lead ECG recorded in the ambulance, and paramedic-applied electrodes retained in place at hospital arrival. An ECG technician applied standard precordial and EASI electrodes in their correct positions. Twelve-lead ECGs were obtained from the paramedic-applied electrodes, using their Mason-Likar limb lead configuration, and derived from the EASI leads for comparison with the stdECG. Three computer-measured QRS-T waveform parameters were considered, and differences in waveform measurement between EASI and stdECG (EASIDeltastdECG) versus differences in waveform measurements between paramedic Mason-Likar and stdECG (PMLDeltastdECG) were calculated. Two physicians determined whether the EASI-derived or the paramedic Mason-Likar ECG contained information that would change their clinical triage decision from that indicated by the stdECG.
Results: EASIDeltastdECG and PMLDeltastdECG were identical in 28%, whereas EASIDeltastdECG was more than PMLDeltastdECG in 35%, and PMLDeltastdECG was accurate (both time) than EASIDeltastdECG in 37% (P = .62). The physicians were more likely to change the level of patient care based on the EASI-derived ECGs compared with the paramedic ECGs; however, this difference was not statistically significant (P = .27), but this may only be caused by the small study population.
Conclusions: There are similar differences from stdECG waveforms in EASI-derived ECGs and those acquired via paramedic-applied precordial electrodes using Mason-Likar limb lead configuration. Either method can be used as a substitute for monitoring, but neither should be considered equivalent to the stdECG for diagnostic purposes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jelectrocard.2005.05.011 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effect of Different ECG Leads on Estimated R-R Intervals and Heart Rate Variability Parameters.
Annu Int Conf IEEE Eng Med Biol Soc
July 2019
Heart rate and heart rate variability parameters provide important information on sympathetic and parasympathetic branches of autonomous nervous system. These parameters are usually extracted from electrocardiograms often measured between two electrodes and called an ECG lead. Besides systems intended only for heart rate measurement, ECG measurement devices employ several well-known lead systems including the standard 12-lead system, EASI lead system and Mason-Likar systems.
View Article and Find Full Text PDFECG monitoring leads and special leads.
Indian Pacing Electrophysiol J
July 2016
Baby Memorial Hospital, Kozhikode, Kerala, India. Electronic address:
ECG monitoring is common place in the hospital and even pre-hospital setting. The need for different types of lead systems in different settings has been emphasised. Simple three electrode bipolar recording is ubiquitous for monitoring.
View Article and Find Full Text PDFComputing the spatial QRS-T angle using reduced electrocardiographic lead sets.
J Electrocardiol
November 2017
Office of Science and Engineering Laboratories, CDRH, US FDA, Silver Spring, MD, USA.
The 'spatial QRS-T angle' (SA) is frequently determined using linear lead transformation matrices that require the entire 12-lead electrocardiogram (ECG). While this approach is adequate when using 12-lead ECG data that is recorded in the resting supine position, it is not optimal in monitoring applications. This is because maintaining a good quality recording of the complete 12-lead ECG in monitoring applications is difficult.
View Article and Find Full Text PDFData Driven Computer Simulation to Analyse an ECG Limb Lead System Used in Connected Health Environments.
Methods Inf Med
May 2016
Raymond R. Bond, Ph.D., School of Computing and Mathematics, University of Ulster, Jordanstown Campus, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, UK, E-Mail:
Background: Recently under the Connected Health initiative, researchers and small-medium engineering companies have developed Electrocardiogram (ECG) monitoring devices that incorporate non-standard limb electrode positions, which we have named the Central Einthoven (CE) configuration.
Objectives: The main objective of this study is to compare ECG signals recorded from the CE configuration with those recorded from the recommended Mason-Likar (ML) configuration.
Methods: This study involved extracting two different sets of ECG limb leads from each patient to compare the difference in the signals.
Normal standards for computer-ECG programs for prognostically and diagnostically important ECG variables derived from a large ethnically diverse female cohort: the Women's Health Initiative (WHI).
J Electrocardiol
July 2014
Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA. Electronic address:
Background: Substantial new information has emerged recently about the prognostic value for a variety of new ECG variables. The objective of the present study was to establish reference standards for these novel risk predictors in a large, ethnically diverse cohort of healthy women from the Women's Health Initiative (WHI) study.
Methods And Results: The study population consisted of 36,299 healthy women.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!