On the detection of QRS variations in the ECG.

Detection of subtle beat-to-beat variations in the morphology of the ECG is complicated by the effects of alignment errors and respiration. A method of directly estimating the alignment error (trigger jitter) from an ECG is derived by relating the variance to the squared slope of the averaged QRS complex. Results based on recordings obtained from 12 normal subjects and alignment performed by the cross-correlation method showed that the alignment errors were dependent upon the choice of the alignment channel, with the best distribution of the errors occurring when alignment was based on the vector magnitude of the three orthogonal leads. The estimated average alignment errors ranged from 0.33-0.42 ms, which were near the optimal value of 0.29 ms based on the sampling rate of 1000 samples/s. It was shown that the effects of respiration could be reduced by normalizing the amplitude of the QRS complexes. It was also estimated that a significant proportion of the variation (0.54-0.67) in the normalized ECG's could be attributed to alignment errors and noise.