Abstract
Background: The presence of noise is problematic in the analysis and interpretation of the ECG, especially in ambulatory monitoring. Restricting the analysis to high-quality signal segments only comes with the risk of excluding significant arrhythmia episodes. Therefore, the development of novel electrode technology, robust to noise, continues to be warranted. Methods: The signal quality of a novel wet ECG electrode (Piotrode) is assessed and compared to a commercially available, commonly used electrode (Ambu). The assessment involves indices of QRS detection and atrial fibrillation detection performance, as well as signal quality indices (ensemble standard deviation and time–frequency repeatability), computed from ECGs recorded simultaneously from 20 healthy subjects performing everyday activities. Results: The QRS detection performance using the Piotrode was considerably better than when using the Ambu, especially for running but also for lighter activities. The two signal quality indices demonstrated similar trends: the gap in quality became increasingly larger as the subjects became increasingly more active. Conclusions: The novel wet ECG electrode produces signals with less motion artifacts, thereby offering the potential to reduce the review burden, and accordingly the cost, associated with ambulatory monitoring.
Highlights
The presence of noise continues to plague the analysis and interpretation of the ECG, salient in recordings obtained under ambulatory conditions
To avoid favoring the Piotrode, lead AI was chosen for signal quality assessment as it tends to be less affected by motion artifacts than leads positioned higher up on the chest [34]
For the other five activities, Se ranges from 99.3% to 100.0% and positive predictive value (PPV) from 99.5% to 100.0% for the Piotrode, whereas, for the Ambu, Se ranges from 87.9% to 98.4% and PPV from 88.8% and 97.1%
Summary
The presence of noise continues to plague the analysis and interpretation of the ECG, salient in recordings obtained under ambulatory conditions. The most straightforward approach to dealing with noise is to employ a signal quality index (SQI), which, in its simplest form, serves as a binary flag indicating whether or not a signal segment should be excluded from further analysis. The presence of noise is problematic in the analysis and interpretation of the ECG, especially in ambulatory monitoring. Methods: The signal quality of a novel wet ECG electrode (Piotrode) is assessed and compared to a commercially available, commonly used electrode (Ambu). The assessment involves indices of QRS detection and atrial fibrillation detection performance, as well as signal quality indices (ensemble standard deviation and time–frequency repeatability), computed from ECGs recorded simultaneously from 20 healthy subjects performing everyday activities. Conclusions: The novel wet ECG electrode produces signals with less motion artifacts, thereby offering the potential to reduce the review burden, and the cost, associated with ambulatory monitoring
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