Key result
Modified 12-lead ECG with posterior leads fails to improve AF frequency correlation versus standard ECG.
Why the study?
Lead V1 correlates strongly with right atrial activity but only moderately with left atrial activity, while posterior lead V9 correlates strongest with left atrial activity, motivating evaluation of modified ECG leads for better left atrial correlation.
Does a modified 12-lead ECG including posterior leads improve correlation with left atrial activity compared to a standard ECG in patients with atrial fibrillation?
Cross-Sectional (n=96)
Does a modified 12-lead ECG including posterior leads improve correlation with left atrial activity compared to a standard ECG in patients with atrial fibrillation?
The inclusion of posterior leads in a modified 12-lead ECG does not improve the correlation of surface dominant AF frequency with left atrial activity compared to a standard ECG.
Answers are grounded in this paper and cite their sources.
Does not support posterior-lead ECG modification for AF frequency analysis; leaves open whether alternative configurations enhance noninvasive left atrial correlation.
BACKGROUND: Lead V1 is routinely analysed due to its large amplitude AF waveform. V1 correlates strongly with right atrial activity but only moderately with left atrial activity. Posterior lead V9 correlates strongest with left atrial activity. AIMS: (1) To establish whether surface dominant AF frequency (DAF) calculated using principal component analysis (PCA) of a modified 12-lead ECG (including posterior leads) has a stronger correlation with left atrial activity compared to the standard ECG. (2) To assess the contribution of individual ECG leads to the AF principal component in both ECG configurations. METHODS: Patients were assigned to modified or standard ECG groups. In the modified ECG, posterior leads V8 and V9 replaced V4 and V6. AF waveform was extracted from one-minute surface ECG recordings using PCA. Surface DAF was correlated with intracardiac DAF from the high right atrium (HRA), coronary sinus (CS) and pulmonary veins (PVs). RESULTS: 96 patients were studied. Surface DAF from the modified ECG did not have a stronger correlation with left atrial activity compared to the standard ECG. Both ECG configurations correlated strongly with HRA, CS and right PVs but only moderately with left PVs. V1 contributed most to the AF principal component in both ECG configurations.
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Raine et al. (2015) conducted a cross-sectional in Atrial fibrillation (n=96). Modified 12-lead ECG (including posterior leads V8 and V9) vs. Standard 12-lead ECG was evaluated on Correlation of surface dominant AF frequency (DAF) with intracardiac DAF from left atrial activity. A modified 12-lead ECG including posterior leads did not improve the correlation of surface dominant atrial fibrillation frequency with left atrial activity compared to a standard ECG.
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