First clinical evaluation of a novel capacitive ECG system in patients with acute myocardial infarction.

Objective: The ECG plays a central role in the rapid diagnosis of acute myocardial infarctions (MI). In haemodynamically instable patients, adhesion of electrodes sometimes is difficult and assessing ECGs through layers of clothes has not been done so far. A novel capacitive measurement of ECG signals is possible without skin contact. Whether this technical innovation can be used in patients with MI is unclear.

Methods: We evaluated a capacitive ECG system (cECG) in patients with anterior and inferior ST elevation MI (STEMI) as compared to patients without ST elevations in anterior and inferior leads. The cECG was assessed using a sensor array consisting of 15 electrodes of which the classical leads I, II, III, aVL, aVF and V(1)-V(3) were calculated from. 66 patients were included in the study. In addition to the conventional ECG (kECG) the novel cECG was registered before reperfusion therapy was started.

Results: In a first round, 19 patients presented with anterior MI, 23 with inferior MI, and 7 either with left bundle branch block or lateral MI. Regarding anterior MI, a significant correlation (P < 0.05) was found between ST elevations in leads I, aVL, V(2) and V(3) comparing cECG and kECG. In inferior MI, there was only a significant correlation (P < 0.05) in lead III between cECG and kECG, but not in II and aVF. Therefore, 17 additional patients were included in the study by placing an additional electrode further away from the sensor array on the chest. ST elevations now correlated in all inferior leads II, III and aVF (P < 0.05) as measured in 9 patients with inferior MI. In addition, in 8 patients an inferior MI was correctly ruled out.

Conclusion: It is possible to identify STEMIs by cECG. This innovative technique could play an important role in the pre-hospital period as well as in the hospital.