A new system of multiple-lead exercise electrocardiography

Mason, Robert E.; Likar, I.N.

doi:10.1016/0002-8703(66)90182-7

Cited by 433 publications

(144 citation statements)

References 13 publications

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“…There was a 7-day washout period between each 24-h treatment period, so subjects received treatments on days 1, 9, 17, 25, and 33. Prior to dosing, a continuous 12-lead ECG recorder (Surveyor, Mortara Instrument, Milwaukee, WI) using the Mason-Likar electrode 14 configuration was connected to each subject. The continuous ECG recordings were made at 500 Hz and with an amplitude resolution of 2.5 μV.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Two Highly Automated ECG Algorithms for Detection of Drug‐Induced Cardiac Ion Channel Block

Brockway

Fossa²,

Mason

2017

Clin Pharma and Therapeutics

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FDA investigators recently demonstrated in a crossover study that early (J-Tpeakc) and late (Tpeak-Tend) repolarization duration can differentiate selective potassium block with a high arrhythmia risk from multichannel block with lower risk in subjects receiving dofetilide, verapamil, quinidine or ranolazine. The purpose of this study was to determine if findings by FDA using their published software algorithm could be corroborated using an alternative software algorithm for the same metrics and to determine if methodological differences resulted in clinically meaningful differences in interpretation. Exposure-response relationships computed with linear mixed effects models and mean maximal effects on ECG intervals measured by the two algorithms were similar, corroborating the FDA findings, but with some differences in the modeled slopes and magnitude of changes. The alternative software resulted in an average 25% reduction in the 95% confidence intervals of the mixed effects models with generally lower Akaike Information Criterion (AIC) values.

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Section: Methodsmentioning

confidence: 99%

Comparison of Two Highly Automated ECG Algorithms for Detection of Drug‐Induced Cardiac Ion Channel Block

Brockway

Fossa²,

Mason

2017

Clin Pharma and Therapeutics

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“…In each subject, a continuous digital 12-lead ECG was recorded for 25 minutes (5 minutes supine → 10 minutes standing → 10 minutes supine) with Mason-Likar electrode positions [11] using a PC-based 12-lead ECG recorder (CardioSoft™, GE Medical Systems, Milwaukee, USA, 500 Hz, 4.88 µV resolution). In each individual, the same protocol was repeated after approximately 1 week at the same time of the day (within±1 hour).…”

Section: Methodsmentioning

confidence: 99%

Effect of heart rate and body position on the complexity of the QRS and T wave in healthy subjects

Batchvarov

Bortolan

Christov

2008

2008 Computers in Cardiology

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We analysed the effect of heart rate and body position on the complexity of the QRS and T wave quantified by the ratio of 2 nd /1 st eigenvalue from principal component analysis (PCA) (QRS-PCA, T-PCA) . In both positions, the intrasubject variability of QRS-PCA and T-PCA was significantly smaller than the inter-subject variability. IntroductionPrincipal component analysis (PCA) quantifies the complexity of the ECG waves by defining a set of independent forms (components) with decreasing relative value, which can fully describe their shape. Visibly more complex QRS or T waves with irregularities, notches, etc., which are frequently observed in diseased hearts are described by a greater number of independent components, with increasing relative value of the smaller components.Whilst the diagnostic [1-3] and prognostic [4,5] value of PCA of the T wave has been demonstrated, the effect of physiological factors on the QRS and T wave complexity is unknown. The T wave shape or polarity can be influenced by age, sex, heart rate, body position, autonomic activity, respiration, temperature, electrolyte concentration, food and mental activity [6][7][8][9][10]. It is possible that these factors can also affect T wave complexity. We investigated the effect of heart rate and body position on QRS and T wave complexity using an ECG database recorded in healthy subjects. MethodsA digital ECG database was previously recoded for another project in 15 subjects (8 men, 7 women, age 28.6±7.5 years, range 21.5 -49.1 years) with negative medical history, normal physical examination and normal resting 12-lead ECG, who were not taking any medications during the project.Data were acquired after 5 minutes of rest in the supine position. In each subject, a continuous digital 12-lead ECG was recorded for 25 minutes (5 minutes supine → 10 minutes standing → 10 minutes supine) with Mason-Likar electrode positions [11] using a PC-based 12-lead ECG recorder (CardioSoft™, GE Medical Systems, Milwaukee, USA, 500 Hz, 4.88 µV resolution). In each individual, the same protocol was repeated after approximately 1 week at the same time of the day (within±1 hour). The local Ethics Committee approved the study protocol and each subject provided a written consent. Data analysisAll ECG recordings were visually assessed on screen using the CardioSoft™ software programme in order to exclude segments with noise or premature beats. The first 2 minutes and the last 30 seconds of recording in each position were excluded from the study, and 2.5 minutes supine → 7.5 minutes standing → 7.5 minutes supine were analysed. The ECG were preprocessed suppressing power-line interference, electromyogram noise and baseline drift according to our previously published material on Q-onset and T-end delineation [12].QRS detection was performed following the work of Christov [13], then one complex lead was synthesised from the initials 8 leads [14]. The QRS and the T wave boundaries as well as the RR interval were delineated and

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“…Arm and precordial electrodes were placed in the standard location recommended by Mason et al 10 50 (P < 0.05) using leads, 52 (P < 0.05) using only the combination of CC,, CM5 and CL and 58 (P < 0.001) using <The CM5, CC5, CL lead system was positive in eight _7 -+ao -: :patients in whom the 11 lead system was negative. The depth of ST-segment depression which occurred in each lead was summed and an ST seg""tnt "index" was established for the 64 patients who had 9ositive test ( fig.…”

Section: Lead Systemmentioning

confidence: 99%

Improved efficiency of treadmill exercise testing using a multiple lead ECG system and basic hemodynamic exercise response.

Chaitman¹,

Bourassa²,

Wagniart³

et al. 1978

Circulation

187

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SUMMARY One hundred consecutive men with a normal ECG at rest had a maximal treadmill test using 14 leads during and postexercise. Coronary arteriography performed the following day revealed coronary stenoses k70% in 66 patients. Test results obtained from a V6 lead were compared to different lead combinations and were correlated with arteriographic findings. A positive exercise test occurred in 37 men using an isolated V, lead compared to 50 men (P < 0.05) using 11 leads, 52 men (P < 0.05) using a combined CM6, CC5, Cl (inferior) lead system and 58 (P < 0.001) men using all 14 leads. The predictive value of a positive test varied between 89-95% and was not changed significantly by the addition of multiple leads. The 14 lead ECG was positive in 43/45 (96%) patients with mul-THE DIAGNOSTIC VALUE OF EXERCISE TESTING has been criticized and defended in recent editorials.'-Redwood and colleagues' have argued that an increased incidence of false positive tests which occur in an asymptomatic population could result in a needless increase in the number of coronary arteriograms which are being performed. Several studies support his concern.'4 In addition, these investigators state that a good clinical history alone is usually adequate in patients with typical angina pectoris and that exercise testing provides superfluous data. Sheffield et al.2 and McHenry3 have defended the value of exercise testing and state that the ECG response is only one of several parameters which should be examined during an exercise test and that the efficiency of this diagnostic procedure can be maximized if a multiple lead system is used. The optimal number of leads required to achieve maximal sensitivity without reducing the predictive value of a positive test has not been well studied. Therefore, we have compared several combinations of lead systems during exercise testing to coronary arteriographic findings in a consecutive series of 100 men who had a normal resting ECG and no previous history of myocardial infarction. Several physiologic responses to exercise such as treadmill endurance time, heart rate, and systolic blood pressure response, and the duration of exercise required to produce ST-segment depression were also studied to determine their usefulness as predictors of multivessel disease. tivessel disease. Parameters which helped to predict multivessel disease using 14 leads were 1) the time that ischemia first appeared 2) the pressurerate product at the time ischemia first appeared, and 3) the maximum workload that could be attained. In general, the magnitude of STsegment depression and the time required for a positive ECG to return to normal postexercise were not useful predictors of multivessel disease.We conclude that the use of multiple leads improves the sensitivity and efficiency of the maximal treadmill exercise test. The usefulness of exercise test results can be further improved if multiple leads are combined with physiologic data collected during exercise. Methods Patient SelectionMaximal treadmill tests were performed o...

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A new system of multiple-lead exercise electrocardiography

Cited by 433 publications

References 13 publications

Comparison of Two Highly Automated ECG Algorithms for Detection of Drug‐Induced Cardiac Ion Channel Block

Comparison of Two Highly Automated ECG Algorithms for Detection of Drug‐Induced Cardiac Ion Channel Block

Effect of heart rate and body position on the complexity of the QRS and T wave in healthy subjects

Improved efficiency of treadmill exercise testing using a multiple lead ECG system and basic hemodynamic exercise response.

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