Non-Standard Electrode Placement Strategies for ECG Signal Acquisition

Q: What is the clinical evidence from this study?

Population: Healthy volunteer for cardiovascular signal monitoring (n=1). Intervention: Non-standard electrode placement configurations (7 thoracic and 1 single-arm) for joint ECG and ICG signal acquisition vs. Standard 3-electrode ECG system on the thorax. Primary outcome: ECG signal quality and median sensitivity of R, S, and T wave detection.

Q: What does this research mean for the field?

Non-standard electrode placement configurations on the thorax and single arm yield recognizable ECG waveforms suitable for wearable joint ECG and ICG acquisition, showing a median R-wave sensitivity of 27.3% compared to 49% for T-waves and 44.9% for S-waves. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Margus Metshein; Andrei Krivošei; Anar Abdullayev; Olev Märtens

doi:10.3390/s22239351

December 1, 2022SensorsOpen Access

Non-Standard Electrode Placement Strategies for ECG Signal Acquisition

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Key result

Non-standard ECG electrode placements yield recognizable waveforms with ~27% median R-wave sensitivity.

n=1

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Why the study?

Expectations for wearable cardiovascular monitoring devices to be unobtrusive and miniaturized require developing smarter devices and better methods for ECG signal acquisition and processing.

Do non-standard thoracic and single-arm electrode placement configurations provide acceptable ECG signal quality for joint ECG and impedance cardiography monitoring in a wearable device context?

Key Points

Evaluate the feasibility of non-standard electrode placement configurations on the thorax and arm for simultaneous electrocardiography and impedance cardiography signal acquisition in wearable devices.
Evaluated non-standard electrode placement configurations on the thorax and a single arm of a single volunteer to assess joint electrocardiography (ECG) and impedance cardiography (ICG) acquisition.
Developed a signal-processing methodology to identify R, S, and T waves and tested a peak-width differentiation algorithm at a 60% threshold to distinguish R waves from oversized T waves.
ECG waveforms from non-standard placements remained recognizable, showing a median wave sensitivity of 27.3% for R waves compared with 49% for T waves and 44.9% for S waves.
The proposed algorithm separated R waves from large T waves using peak widths that were 2 to 3 times larger for T waves, producing zero false positives in tested signal sequences.
Joint assessment identified thoracic configurations TEPC-1 and TEPC-7 as the most recommendable electrode placements for simultaneous ECG and ICG signal detection.

Structured PICO

Do non-standard thoracic and single-arm electrode placement configurations provide acceptable ECG signal quality for joint ECG and impedance cardiography monitoring in a wearable device context?

P

Population

1 healthy, slim adult volunteer aged 37 years undergoing experimental ECG and impedance cardiography signal acquisition.

I

Intervention

8 non-standard electrode placement configurations (EPCs)—7 on the thoracic area (TEPC 1-7) and 1 on a single arm (AEPC)—for joint acquisition of ECG and ICG signals using a custom bipolar 3-lead ECG monitor (AD8232ACPZ front-end) and 3M 2228 electrodes, evaluated alongside a novel peak-property algorithm to distinguish R waves from large T waves.

C

Comparator

Standard 3-electrode ECG monitoring system (LA, RA, LL attached at equal distances on the thorax).

O

Outcome

ECG signal quality assessment (categorized as acceptable or conditionally acceptable based on R, S, and T wave visibility, heart rate, and wave amplitudes) and median sensitivity (relative peak amplitude variation) of R, S, and T waves.surrogate

Limitations

Data acquired from only a single volunteer (n=1), requiring a larger sample size for verification
Electrode placement configurations were pre-selected rather than derived from full-body mapping
Signal quality assessment relied only on selected time-domain fiducial points without frequency domain features
Proposed R-wave distinguishing algorithm requires verification on a larger number of signals and comparison with existing models
Only data acquired from a single volunteer (n=1) were utilized
Electrode placement configurations were pre-selected based on practical experience rather than full-body mapping
Signal quality assessment was limited to selected fiducial points in the time domain
The proposed R-wave and T-wave distinguishing algorithm needs verification on a larger dataset and comparison against existing models

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Implication

This proof-of-concept study demonstrates the feasibility of acquiring recognizable ECG waveforms from non-standard thoracic and single-arm electrode locations shared with impedance cardiography sensors for compact wearable device design.

Abstract

BACKGROUND: Wearable technologies for monitoring cardiovascular parameters, including electrocardiography (ECG) and impedance cardiography (ICG), propose a challenging research subject. The expectancy for wearable devices to be unobtrusive and miniaturized sets a goal to develop smarter devices and better methods for signal acquisition, processing, and decision-making. METHODS: In this work, non-standard electrode placement configurations (EPC) on the thoracic area and single arm were experimented for ECG signal acquisition. The locations were selected for joint acquisition of ECG and ICG, targeted to suitability for integrating into wearable devices. The methodology for comparing the detected signals of ECG was developed, presented, and applied to determine the R, S, and T waves and RR interval. An algorithm was proposed to distinguish the R waves in the case of large T waves. RESULTS: Results show the feasibility of using non-standard EPCs, manifesting in recognizable signal waveforms with reasonable quality for post-processing. A considerably lower median sensitivity of R wave was verified (27.3%) compared with T wave (49%) and S wave (44.9%) throughout the used data. The proposed algorithm for distinguishing R wave from large T wave shows satisfactory results. CONCLUSIONS: The most suitable non-standard locations for ECG monitoring in conjunction with ICG were determined and proposed.

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Cite This Study

Metshein et al. (2022) studied Healthy volunteer for cardiovascular signal monitoring (n=1). Non-standard electrode placement configurations (7 thoracic and 1 single-arm) for joint ECG and ICG signal acquisition vs. Standard 3-electrode ECG system on the thorax was evaluated on ECG signal quality and median sensitivity of R, S, and T wave detection. Non-standard electrode placement configurations yielded recognizable ECG waveforms with a median R-wave sensitivity of 27.3% compared with 49% for T-waves and 44.9% for S-waves.

synapsesocial.com/papers/6a7ca59f00c891f5b77cce5b https://doi.org/10.3390/s22239351

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Non-Standard Electrode Placement Strategies for ECG Signal Acquisition

Figures

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Non-Standard Electrode Placement Strategies for ECG Signal Acquisition

Figures

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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