TY - JOUR
T1 - Superiority of a vertical sternal lead for detection of arrhythmias during ambulatory electrocardiographic monitoring
AU - Ott, Peter
AU - Marcus, Frank I.
AU - Scott, William A.
AU - Caruso, Anthony C.
AU - Faitelson, Lionel H.
AU - Hahn, Elizabeth
PY - 1992/3/1
Y1 - 1992/3/1
N2 - In a preliminary study comparing 7 sets of bipolar leads with standard modified V1 and V5 leads, a vertical sternal lead system with the negative lead just below the suprasternal notch, and the positive lead over the xiphoid had the greatest P-wave area. In the current study, the vertical sternal and modified V1 leads were obtained simultaneously using 2-channel ambulatory electrocardiographic recorders in 50 consecutive patients undergoing diagnostic ambulatory electrocardiography for suspected arrhythmias. The vertical sternal lead provided tracings with a larger P-Wave area compared with that of the modified V1 (0.58 ± 0.44 vs 1.23 ± 0.69 mm2; p < 0.0001), and a greater QRS complex (9.23 ±4.16 vs 11.78 ± 4.90 mm; p = 0.006). During premature atrial contractions and supraventricular tachycardia, P-wave visibility was significantly better in the sternal lead than in V1 (p < 0.001). Furthermore, sternal lead tracings were superior with regard to overall quality and noise level. It is suggested that the vertical sternal lead replace the currently used modified V1 during ambulatory electrocardiographic monitoring. This lead system in conjunction with the standard modified V5 lead should be useful in the differential diagnosis of atrial arrhythmias.
AB - In a preliminary study comparing 7 sets of bipolar leads with standard modified V1 and V5 leads, a vertical sternal lead system with the negative lead just below the suprasternal notch, and the positive lead over the xiphoid had the greatest P-wave area. In the current study, the vertical sternal and modified V1 leads were obtained simultaneously using 2-channel ambulatory electrocardiographic recorders in 50 consecutive patients undergoing diagnostic ambulatory electrocardiography for suspected arrhythmias. The vertical sternal lead provided tracings with a larger P-Wave area compared with that of the modified V1 (0.58 ± 0.44 vs 1.23 ± 0.69 mm2; p < 0.0001), and a greater QRS complex (9.23 ±4.16 vs 11.78 ± 4.90 mm; p = 0.006). During premature atrial contractions and supraventricular tachycardia, P-wave visibility was significantly better in the sternal lead than in V1 (p < 0.001). Furthermore, sternal lead tracings were superior with regard to overall quality and noise level. It is suggested that the vertical sternal lead replace the currently used modified V1 during ambulatory electrocardiographic monitoring. This lead system in conjunction with the standard modified V5 lead should be useful in the differential diagnosis of atrial arrhythmias.
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U2 - 10.1016/0002-9149(92)90153-P
DO - 10.1016/0002-9149(92)90153-P
M3 - Article
C2 - 1536112
AN - SCOPUS:0026600874
SN - 0002-9149
VL - 69
SP - 625
EP - 627
JO - The American Journal of Cardiology
JF - The American Journal of Cardiology
IS - 6
ER -