Abstract
Surface Laplacian estimates via concentric ring electrodes (CREs) have proven to enhance spatial resolution compared to conventional disc electrodes, which is of great importance for P-wave analysis. In this study, Laplacian estimates for traditional bipolar configuration (BC), two tripolar configurations with linearly decreasing and increasing inter-ring distances (TCLDIRD and TCLIIRD, respectively), and quadripolar configuration (QC) were obtained from cardiac recordings with pentapolar CREs placed at CMV1 and CMV2 positions. Normalized P-wave amplitude (NAP) was computed to assess the contrast to study atrial activity. Signals were of good quality (20–30 dB). Atrial activity was more emphasized at CMV1 (NAP ≃ 0.19–0.24) compared to CMV2 (NAP ≃ 0.08–0.10). Enhanced spatial resolution of TCLIIRD and QC resulted in higher NAP values than BC and TCLDIRD. Comparison with simultaneous standard 12-lead ECG proved that Laplacian estimates at CMV1 outperformed all the limb and chest standard leads in the contrast to study P-waves. Clinical recordings with CRE at this position could allow more detailed observation of atrial activity and facilitate the diagnosis of associated pathologies. Furthermore, such recordings would not require additional electrodes on limbs and could be performed wirelessly, so it should also be suitable for ambulatory monitoring, for example, using cardiac Holter monitors.
Highlights
Cardiovascular disease is the principal cause of morbidity and mortality in developed countries, and in ten years it is expected to become the main cause of death worldwide [1,2]
Comparison with simultaneous standard 12-lead ECG proved that Laplacian estimates at CMV1 outperformed all the limb and chest standard leads in the contrast to study P-waves
As seen in panel (b) the morphology barely changed between the different Laplacian estimates while it changed substantially in panel (a)
Summary
Cardiovascular disease is the principal cause of morbidity and mortality in developed countries, and in ten years it is expected to become the main cause of death worldwide [1,2]. While mortality associated with cardiovascular disease tends to decrease [3], its costs are expected to increase substantially over the two decades, mostly due to aging populations [4]. In the European Union, costs associated with cardiovascular disease amount to approximately €169 billion per year [5]. Electrocardiogram (ECG) is the recording of a vital signal extensively used in diagnostics. It provides information about the heart rate and about the electrical conduction in the heart. Standard 12-lead ECG does not perform well in the diagnosis of pathologies related to local electrical conduction abnormalities in the heart, such as ventricular ischemia, Sensors 2019, 19, 3780; doi:10.3390/s19173780 www.mdpi.com/journal/sensors
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