Enhancing electrocardiographic analysis by combining a high-resolution 12-lead ECG with novel software tools

Abstract

Introduction: Signal-averaged electrocardiography is a non-invasive, computerized technique that amplifies, filters, and averages cardiac electrical signals reducing contaminating noise to obtain a high-resolution record. The most widely used signal averaging (SA) method involves a bipolar X, Y, and Z orthogonal lead system. Information is limited regarding its application in the standard resting 12-lead ECG. A novel system combining a high-resolution 12-lead ECG (HR-ECG) registered by SA with advanced analysis tools is presented.

History: Original programming of a commercially available signal-averaged HR-ECG device was modified, introducing more exhaustive electrocardiographic assessment instruments.

Description: Using SA techniques and placing surface electrodes in the standard 12-lead ECG positions, a HR-ECG is acquired within a bandwidth of 0.25 to 262 Hz at a rate of 1000 samples per second. It is advisable to average at least 200 cycles, taking three to five minutes to record. The package includes different optional high-frequency filters, manual calipers, zoom/superimposing/amplification functions.

Clinical role: The main strength lies in obtaining a low noise HR-ECG with zooming capabilities without definition loss. Other potential advantages are the greater ease in performing high precision analysis and comparing different ECG leads simultaneously.

Current problems: The primary limitation is the inability to document intermittent or dynamic electrocardiographic disorders because of averaging similar electrical cardiac cycles.

Future developments: Adding artificial intelligence and further refinements in the averaging process could lead to software upgrades.

Conclusion: Integrating HR-ECG, obtained through SA techniques, with novel advanced analysis tools can enhance the ability to detect electrocardiographic disorders of permanent expression expeditiously.

Keywords: Delta wave; Epsilon wave; High-resolution electrocardiogram; P wave; Signal-averaged electrocardiogram.