Welinder Annika, Sörnmo Leif, Feild Dirk Q, Feldman Charles L, Pettersson Jonas, Wagner Galen S, Pahlm Olle
Department of Clinical Physiology, University Hospital, Lund, Sweden.
Am J Crit Care. 2004 May;13(3):228-34.
Myoelectric noise and baseline wander, artifacts that appear when patients move during electrocardiographic monitoring, can cause false alarms. This problem can be addressed by using a reduced lead set and placing electrodes on the anterior part of the torso only. The Mason-Likar modification of the standard 12-lead electrocardiogram and the EASI lead system are 2 alternative systems for lead placement.
To test the hypothesis that the EASI lead system is less susceptible to artifacts than is the Mason-Likar modification of the standard 12-lead electrocardiogram.
Baseline wander and myoelectric noise amplitudes of EASI and Mason-Likar 12-lead electrocardiograms were compared. Twenty healthy volunteers participated. Both lead systems were recorded simultaneously for different types of physical activities. For each lead in each subject, baseline wander and myoelectric noise were measured for both systems, at rest and during each physical activity.
The outcome for baseline wander was mixed. For myoelectric noise content, the EASI system performed better for the limb leads in the different physical activities. In the precordial leads, the differences were minimal or mixed. However, for supine-to-right turning, EASI performed worse than the Mason-Likar system.
The 2 systems have similar susceptibilities to baseline wander. The EASI system is, however, less susceptible to myoelectric noise than is the Mason-Likar system. EASI performed worse than Mason-Likar for turning supine to right, because only the EASI system uses an electrode in the right-midaxillary line.
肌电噪声和基线漂移是心电图监测过程中患者移动时出现的伪迹,可导致误报。使用简化导联组并仅将电极放置在躯干前部可解决此问题。标准12导联心电图的梅森 - 利卡尔改良法和EASI导联系统是两种替代的导联放置系统。
检验EASI导联系统比标准12导联心电图的梅森 - 利卡尔改良法更不易受伪迹影响这一假设。
比较EASI和梅森 - 利卡尔12导联心电图的基线漂移和肌电噪声幅度。20名健康志愿者参与。两种导联系统针对不同类型的身体活动同时进行记录。对于每个受试者的每个导联,在静息状态和每种身体活动期间,对两种系统测量基线漂移和肌电噪声。
基线漂移的结果不一。对于肌电噪声含量,在不同身体活动中,EASI系统在肢体导联方面表现更好。在前胸导联中,差异最小或不一。然而,对于从仰卧位向右侧翻身,EASI的表现比梅森 - 利卡尔系统差。
这两种系统对基线漂移的易感性相似。然而,EASI系统比梅森 - 利卡尔系统更不易受肌电噪声影响。对于从仰卧位向右侧翻身,EASI的表现比梅森 - 利卡尔差,因为只有EASI系统在右腋中线使用了一个电极。