Abstract
Background The standard electrocardiogram (ECG) is commonly performed in the supine posture. It may be difficult to report ECG in a supine posture for those who are unable to adopt the supine posture because of certain circumstances such as acute respiratory distress syndrome—patients who are placed in a prone position for long periods to improve oxygenation. Few data are available on the impact of the prone position on the ECG recording with electrodes on the posterior chest. Examining and analyzing the type and extent of changes observed in the prone ECG in healthy adults have become vitally valuable. Methods A cross-sectional observational study enrolled forty healthy adults (24 males and 16 females) aged between 18 and 40 years. The ECG was performed in two different body positions, supine and prone. Influence of prone position on the heart rate, mean QRS axis, amplitude, morphology, duration, mean T wave axis and polarity, mean P wave axis, PR, and mean QTc duration was evaluated. Results The mean heart rate was higher in the prone position (73.2 ± 12.4 bpm) compared with the supine position (69.5 ± 11.5 bpm, p = 0.03). The QRS duration decreased considerably from supine (92.8 ± 12.6 ms) to prone (84.9 ± 11.9 ms, p < 0.001). The mean QRS axis moved to the left in the prone posture (40.5° ± 32°) relative to the supine (49° ± 28°, p=0.015). The QRS amplitude in the precordial leads was significantly decreased from supine (7.42 ± 3.1 mV) to prone (3.68 ± 1.7 mV, p < 0.001). In addition, changes in the QRS morphology in leads V1–V3 with the appearance of new Q waves were noted. A notable variation in the mean corrected QT (QTc) period with decrease in duration in prone posture ECG (385 ± 64.8) relative to supine (406 ± 18.8, p=0.05). Conclusions Prone position ECG resulted in significant changes in healthy adults that should be aware of this as this can affect diagnosis and management strategies. Further studies are needed to investigate the impact of prone position on ECG recording in patients with cardiovascular diseases.
Highlights
Yunis Daralammouri,1,2 Murad Azamtta,1 Hamza Hamayel,3 Amro Adas,3 Osama Sawalmeh,3 Yahia Ismail,1,2 and Saed H
Results. e mean heart rate was higher in the prone position (73.2 ± 12.4 bpm) compared with the supine position (69.5 ± 11.5 bpm, p 0.03). e QRS duration decreased considerably from supine (92.8 ± 12.6 ms) to prone (84.9 ± 11.9 ms, p < 0.001). e mean QRS axis moved to the left in the prone posture (40.5° ± 32°) relative to the supine (49° ± 28°, p 0.015). e QRS amplitude in the precordial leads was significantly decreased from supine (7.42 ± 3.1 mV) to prone (3.68 ± 1.7 mV, p < 0.001)
It is an effective method to diagnose ischemic changes, arrhythmia, conduction defects, drug and toxin effects, and electrolyte disturbances [1, 2]. e conventional ECG is usually reported in the supine posture, and the definition of different normal variables is determined on the basis of ECG recordings in the supine position
Summary
Yunis Daralammouri ,1,2 Murad Azamtta ,1 Hamza Hamayel ,3 Amro Adas ,3 Osama Sawalmeh ,3 Yahia Ismail ,1,2 and Saed H. A notable variation in the mean corrected QT (QTc) period with decrease in duration in prone posture ECG (385 ± 64.8) relative to supine (406 ± 18.8, p 0.05). Prone position ECG resulted in significant changes in healthy adults that should be aware of this as this can affect diagnosis and management strategies. E conventional ECG is usually reported in the supine posture, and the definition of different normal variables is determined on the basis of ECG recordings in the supine position. In those who are unable to adopt the supine posture owing to certain limitations requiring them to take. A prone posture may be used in morbidly obese patients and patients with burns, skin flaps, or cut wounds in the back of the body
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