An alternative limb lead system for electrocardiographs in emergency patients

Takuma, Kiyotsugu; Hori, Shingo; Sasaki, Junichi; Shinozawa, Yotaro; Yoshikawa, Tsutomu; Handa, Shunnosuke; Horikawa, Muneyuki; Aikawa, Naoki

doi:10.1016/0735-6757(95)90160-4

Cited by 22 publications

(25 citation statements)

References 12 publications

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“…Cardiac activity (electrocardiogram [ECG]) was recorded using BioPac MP150 system (BioPac Systems Inc., USA) and the AcqKnowledge Software 4.3 with a sampling frequency of 1,000 Hz. To maximize the QRS signal, ECG electrodes were placed according to a modified Lead II configuration (Takuma et al, ) on the right and left subclavicular spaces (the deltopectoral fossae) and on the left lower rib. About 5 min of activity were recorded before starting the experiment to allow participants to adapt to the recording equipment.…”

Section: Methodsmentioning

confidence: 99%

The heart of cognitive control: Cardiac phase modulates processing speed and inhibition

et al. 2019

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Bodily states are heavily intertwined with cognitive processes. A prominent communication channel between bodily signals and brain structures is provided by baroreceptors. Their phasic activity associated with the cardiac phase has been shown to modulate cognitive control in socio‐emotional contexts. However, whether this effect is specific to the affective dimension or impacts general cognitive control processes remains controversial. The aim of the present study is to investigate the effect of cardiac phase on different facets of cognitive control. We built a nonemotional cognitive control task to delineate mechanisms such as processing speed, response selection, response inhibition, and conflict monitoring. We showed that the systole (after the blood is ejected from the heart), compared to the diastole, was related to faster responses. Moreover, the cardiac phase dynamics also impacted response inhibition, with an increased probability of failure toward the middle of the course of systole. Although the reported effects were small in terms of magnitude, they highlight the influence of bodily states on abstract cognitive processes.

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Section: Methodsmentioning

confidence: 99%

The heart of cognitive control: Cardiac phase modulates processing speed and inhibition

et al. 2019

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“…22 However, in most circumstances, the torso position should not replace the standard position on the limbs. The torso position induces a change in how the electrical vectors are recorded.…”

Section: ↓ ↓mentioning

confidence: 99%

Electrocardiography Pitfalls and Artifacts: The 10 Commandments

Baranchuk

Shaw

Alanazi

et al. 2009

Critical Care Nurse

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“…1-3 The Mason-Likar (M-L) ECG lead adaptation for stress testing relocated the wrist electrodes to the medial border of deltoid, 2 cm below the lower border of the clavicle in the right and left infra-clavicular fossae, and the left leg electrode to the anterior axillary line midway between the iliac crest and the costal margin. Using a similar modification for resting 12-lead electrocardiography was suggested by Takuma et al in 1994, 4 to permit easier application in an emergency. Limb leads were relocated to the anterior acromial region and anterior superior iliac spines bilaterally and seemed to have little overall effect on the ECG.…”

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confidence: 99%

Modified electrode placement must be recorded when performing 12-lead electrocardiograms

Jowett¹,

Turner²,

Cole³

et al. 2005

Postgraduate Medical Journal

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Background Local observation has suggested that placing limb leads on the torso when recording the standard 12-lead resting electrocardiogram (ECG) has become commonplace. This non-standard modification has the important advantages of ease and speed of application, and in an emergency may be applied with minimal undressing. Limb movement artefact is also reduced. It is believed that ECGs obtained with torso electrodes are interchangeable with standard ECGs and any minor electrocardiographic variations do not affect diagnostic interpretation. Study design The study compared 12-lead ECGs in 100 patients during routine electrocardiography, one being taken in the approved way and one taken with modified limb electrodes. Results It was found that the use of torso leads produced important amplitude and waveform changes associated with a more vertical and rightward shift of the QRS frontal axis, particularly in those with abnormal standard ECGs. Such changes generated important ECG abnormalities in 36% of patients with normal standard ECGs, suggesting “heart disease of electrocardiographic origin”. In those with abnormal standard ECGs, moving the limb leads to the torso made eight possible myocardial infarcts appear and five inferior infarcts disappeared. Twelve others developed clinically important T wave or QRS frontal axis changes. Conclusions It is vital that ECGs should be acquired in the standard way unless there are particular reasons for not doing so, and that any modification of electrode placement must be reported on the ECG itself. Marking the ECG “torso-positioned limb leads” or “non-standard” should alert the clinician to its limitations for clinical or investigative purposes, as any lead adaptation may modify the tracing and could result in misinterpretation.

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An alternative limb lead system for electrocardiographs in emergency patients

Cited by 22 publications

References 12 publications

The heart of cognitive control: Cardiac phase modulates processing speed and inhibition

The heart of cognitive control: Cardiac phase modulates processing speed and inhibition

Electrocardiography Pitfalls and Artifacts: The 10 Commandments

Modified electrode placement must be recorded when performing 12-lead electrocardiograms

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