Precordial electrocardiographic recording and QT measurement from a novel wearable ring device

Abstract

BackgroundThe availability of portable and wearable electrocardiography devices has increased secondary to technological development. Single-lead ECG recordings have been shown to reliably detect and characterize cardiac rhythms such as atrial fibrillation. Acquisition of precordial electrodes for full 12-lead ECG reconstruction from bipolar recordings is complicated by the absence of a body ground / Wilson central terminal electrode, however the extent of difference between standard precordial lead and those from a wearable bipolar ECG recorder has not been characterized. ObjectiveThis study characterizes precordial ECG lead set from sequential bipolar recordings from an ECG ring wearable device. MethodsIn 70 patients wearing an ECG device on their right finger, sequential precordial leads (CR1-CR6) were obtained along with chest electrodes (V1-V6). During acquisition of the modified precordial lead CR6 a full standardized 12 lead ECG capture was obtained.Using automated analysis software, signal quality was assessed, and the correlation values between the ring-derived ECG precordial leads and standard ECG leads were compared with QRS duration, QT width, and RR interval measurement. ResultsThere is high concordance in the morphology of precordial ECG leads obtained in a standard fashion and those recorded through an ECG ring. Morphologic alignment improved with increasing laterality of the precordial lead with chest to right arm ring recording (CR5, CR6) compared with anterior chest leads to right arm (CR1, CR2). Segmental measurements of QRS duration and QT segment were well aligned and of high correlation. ConclusionWearable ring based electrocardiographic technology is capable of high fidelity recording of precordial leads for non-simultaneous reconstruction of complete ECG sets. These correlate highly with surface-obtained QRS and QT duration measurement, which has significant implications for clinical applications. Uninterpretable tracings were primarily due to electrode noise from poor electrode contact.