Takuma K, Hori S, Sasaki J, Shinozawa Y, Yoshikawa T, Handa S, Horikawa M, Aikawa N
Department of Emergency Medicine, Keio University, School of Medicine, Tokyo, Japan.
Am J Emerg Med. 1995 Sep;13(5):514-7. doi: 10.1016/0735-6757(95)90160-4.
It is occasionally difficult to record the standard 12-lead electrocardiograph (ECG) in emergency patients. The aim of this study was to evaluate the influence on electrocardiographic wave form recordings of moving the location of electrodes from the standard limb lead position to the trunk. The participants were 10 normal subjects and 20 patients with heart disease. In the new lead system, the limb electrodes were placed on the anterior acromial region and the anterior superior iliac spine using adhesive electrodes. Conventional 12-lead ECGs were recorded by the standard and the new lead system simultaneously in the supine position. Wave form analysis was done by an automatic analysis program. Motion artifacts in the recordings were less in the new lead system. The R wave amplitude of the new lead system increased in leads II, III and aVF, and decreased in leads I and aVL. However, the amplitudes of each wave obtained by standard electrocardiography and the new lead system correlated well (y = 1.008x + 2.038, r = 0.99, n = 2,880). In 99.6% of all wave forms, the differences in amplitudes were within 5% of the values of standard recordings. The average of differences in the ST-segment was 2.6 +/- 11.4 microV. The frontal plane QRS axis obtained by the new lead system showed a vertical shift of 7.8 +/- 8.5 degrees (y = 0.94911x + 10.346, r = 0.98, n = 30). The recording errors produced by the new lead system were within the permissible range of variation. The new lead system is a reasonable alternative for recording ECGs if application of the standard lead is difficult in an emergency.
在急诊患者中，有时很难记录标准的12导联心电图（ECG）。本研究的目的是评估将电极位置从标准肢体导联位置移至躯干对心电图波形记录的影响。参与者包括10名正常受试者和20名心脏病患者。在新导联系统中，使用粘性电极将肢体电极置于肩峰前区和髂前上棘。在仰卧位同时通过标准导联系统和新导联系统记录常规12导联心电图。通过自动分析程序进行波形分析。新导联系统记录中的运动伪影较少。新导联系统在II、III和aVF导联中的R波振幅增加，而在I和aVL导联中降低。然而，标准心电图和新导联系统获得的各波振幅相关性良好（y = 1.008x + 2.038，r = 0.99，n = 2880）。在所有波形的99.6%中，振幅差异在标准记录值的5%以内。ST段差异的平均值为2.6±11.4微伏。新导联系统获得的额面QRS轴显示垂直偏移7.8±8.5度（y = 0.94911x + 10.346，r = 0.98，n = 30）。新导联系统产生的记录误差在允许的变化范围内。如果在紧急情况下难以应用标准导联，新导联系统是记录心电图的合理替代方法。
