Is surface ECG a useful surrogate for subcutaneous ECG?

Pacing and Clinical Electrophysiology : PACE
Carissa L Bellardine BlackRobert G Tieleman

Abstract

Surface electrocardiograms (ECGs) have been used as surrogates for subcutaneous ECGs to optimize and evaluate subcutaneous devices, but differences between surface and subcutaneous ECGs remain poorly understood. This study evaluated the correspondence between surface and subcutaneous ECGs in Reveal Plus (Medtronic Inc., Minneapolis, MN, USA) patients during various maneuvers. Surface electrodes were placed over the Reveal electrodes of 48 subjects (23 men, age 60 +/- 14.3 years, body mass index 27 +/- 4.9 kg/m(2), implant time 45 +/- 29 weeks). Surface and subcutaneous ECGs were recorded simultaneously for 30 seconds during rest, isometric myopotential noise (pushing palms together), and artifact-inducing maneuvers (repetitive displacement of device, chest thumping on device, arm flaps, handshake, hallwalk). During rest, subcutaneous and surface ECGs were highly correlated (R = 0.96), had similar R-wave amplitude (487 +/- 40 vs 507 +/- 49 microV, NS), and signal-to-noise ratio (SNR) (13.4 +/- 0.8 vs 13.5 +/- 0.7, NS). During myopotential noise, subcutaneous and surface ECGs were highly correlated (R = 0.91) and had similar SNR (10.0 +/- 0.6 vs 9.7 +/- 0.6, NS). During artifact-inducing maneuvers, subcutaneous and surface ECGs w...Continue Reading

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Citations

Feb 27, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Kent VolosinPaulus Kirchhof
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