Bipolar esophageal electrocardiography by using standard limb leads

Towards Improving the Quality of Electrophysiological Signal Recordings by Using Microneedle Electrode Arrays

OBJECTIVE

Electrophysiological signals are recorded generally by metal electrodes placed on body surface. For long term use, the signal quality may decay with the change of interface impedance between electrodes and skin due to the conductive hydrogel dehydration. Besides, electrodes may shift during body movements, which causes unstable signal recordings.

METHODS

To improve the quality of electrophysiological signal recordings on human body surface, a type of microneedle electrode array (MEA) with microneedles around 550 μm in length was fabricated with a magnetization-induce self-assembly method.

RESULTS

Compared with the commonly used dry electrode array, the MEA has lower and more stable interface impedance, especially when the electrode-skin interface is under unstable pressures. For electrophysiological signal recording, the MEA can acquire electromyography (EMG) with significantly lower noise energy, higher signal-to-noise ratio, and higher motion-classification accuracy based on the EMG pattern-recognition method. Additionally, high quality electrocardiography (ECG) can be recorded by using the MEA, where more accurate R-peaks are extracted in different scenarios. Besides, there was no report about any discomfort like bleeding or inflammation by all the subjects.

CONCLUSION

This research proved that the microneedles on the MEA can penetrate through the corneum and reach the epidermis of the subjects, which could avoid the influence of corneum and fix the electrode on the body surface for high-quality signal recording especially during body movements. Furthermore, the microneedles would not touch the dermis, enabling a painless signal acquisition.

SIGNIFICANCE

This work is beneficial to the applications of wearable human-machine interface technology.

The combined use of esophageal electrocardiogram and multiple right parasternal chest leads in the diagnosis of PSVT and determination of accessory pathways involved: A new simple noninvasive approach

INTRODUCTION

Paroxysmal Supraventricular Tachycardia (PSVT) resulting from any cause can at times lead to diagnostic difficulty mainly when due to AVNRT and AVRT. In this study we used a non-invasive approach using esophageal ECG (ECGe) and ECG derived from the various right parasternal chest leads (RPCL) to correctly diagnose the type of PSVT as well the accessory pathways involved in AVRT.

METHODS AND RESULTS

We studied a total of 161 patients (89 male) all having a history of palpitation. All the patients underwent routine 12 lead ECG, ECGe, RPCL and electrophysiologic study. With use of ECGe and RPCL, 71 (44.1%) were diagnosed as having AVNRT and 90 (55.9%) having AVRT with various accessory pathways compared to only 49 (30.4%) and 22 (13.7%) respectively with routine 12 lead ECG. With combined ECGe and RPCL, 80 (49.7%) showed accessory pathway in the left free wall, 4 (2.5%) showed in the right free wall, 6 (3.7%) septal accessory pathway, 60 (37.3%) in the anterior wall and 30 (18.6%) in the posterior wall. In comparison, EPS could show accessory pathways in the left free wall in 81 (50.3%), in the right free wall in 5 (3.1%), in the septum in 4 (2.5%), in the anterior wall in 53 (32.9%) and in the posterior wall in 37 (23.0%) out of the 161 patients.

CONCLUSIONS

ECGe+RPCL can be used as a reliable noninvasive diagnostic tool to identify the nature of tachycardia and the pathways involved in the reentrant ring of PSVT especially in those with multiple atrioventricular accessory pathways or a combination of atrioventricular accessory pathways and dual atrioventricular nodal pathway.