Comparison of one- and three-lead ECG to measure cardiac intervals and differentiate drug-induced multi-channel block

Brockway, Robert; Brockway, Marina; Brockway, Brian; Hamlin, Robert L.

doi:10.1016/j.vascn.2018.04.004

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…2 The composite ECG data obtained in this study suggest that a combination of multiple leads can provide an accurate alternative to single-lead ECG to measure JTp and Tpe intervals as previously demonstrated by Brockway and colleagues. 48 The use of composite ECG in the current study resulted in reduced variability of both the JTp and Tpe intervals as well as an attenuation of artifacts that affect a single derivation. Although single-lead ECG can produce adequate PR, RR, QRS, and QT results, it also produces more variable results when assessing QT, JTp, and Tpe in comparison to composite ECG.…”

Section: Discussionmentioning

confidence: 87%

“…Furthermore, JTp and Tpe measured with sM are less susceptible to T-wave morphology changes induced by posture and respiration. 48 In a recent clinical study, a VCG was used to represent the cardiac activation across the whole heart TdP. 2 This technique measures the early and late repolarization intervals (JTp, Tpe).…”

Section: Discussionmentioning

confidence: 99%

“…16 Nevertheless, multiple-lead ECG has been used to produce less variable QT intervals compared to the single-lead ECG normally used in preclinical studies. 48 Clinically, VCG representations simplify the description of space-time cardiac pathological patterns and enhance the automatic evaluation of cardiovascular diseases. 50 The advantage of the VCG over ECG is that VCG provides three-dimensional information on the electrical activity of the heart, allowing for improved spatial and temporal representation of cardiac depolarization and repolarization.…”

Section: Discussionmentioning

confidence: 99%

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Confounders and Pharmacological Characterization When Using the QT, JTp, and Tpe Intervals in Beagle Dogs

et al. 2020

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Introduction: Corrected QT (QTc) interval is an essential proarrhythmic risk biomarker, but recent data have identified limitations to its use. The J to T-peak (JTp) interval is an alternative biomarker for evaluating drug-induced proarrhythmic risk. The aim of this study was to evaluate pharmacological effects using spatial magnitude leads and DII electrocardiogram (ECG) leads and common ECG confounders (ie, stress and body temperature changes) on covariate adjusted QT (QTca), covariate adjusted JTp (JTpca), and covariate adjusted T-peak to T-end (Tpeca) intervals. Methods: Beagle dogs were exposed to body hyper- (42 °C) or hypothermic (33 °C) conditions or were administered epinephrine to assess confounding effects on heart rate corrected QTca, JTpca, and Tpeca intervals. Dofetilide (0.1, 0.3, 1.0 mg/kg), ranolazine (100, 140, 200 mg/kg), and verapamil (7, 15, 30, 43, 62.5 mg/kg) were administered to evaluate pharmacological effects. Results: Covariate adjusted QT (slope −12.57 ms/°C) and JTpca (−14.79 ms/°C) were negatively correlated with body temperature but Tpeca was minimally affected. Epinephrine was associated with QTca and JTpca shortening, which could be related to undercorrection in the presence of tachycardia, while minimal effects were observed for Tpeca. There were no significant ECG change following ranolazine administration. Verapamil decreased QTca and JTpca intervals and increased Tpeca, whereas dofetilide increased QTca and JTpca intervals but had inconsistent effects on Tpeca. Conclusion: Results highlight potential confounders on QTc interval, but also on JTpca and Tpeca intervals in nonclinical studies. These potential confounding effects may be relevant to the interpretation of ECG data obtained from nonclinical drug safety studies with Beagle dogs.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Confounders and Pharmacological Characterization When Using the QT, JTp, and Tpe Intervals in Beagle Dogs

et al. 2020

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“…There are also wearable three-lead ECGs Open access such as the ZioPatch 25 and the Nuvant mobile cardiac telemetry. 26 Three-lead ECGs appear to be comparable with single-lead ECGs when assessing most intervals 27 ; however, they do require longer application periods to obtain true readings and there can be a greater delay in accessing and reporting the ECG data. 25 Integration of single-lead ECG devices into existing pathways has been demonstrated to be feasible in primary care, 10 11 opportunistically in pharmacies, 12 13 in lowresource settings, 14 in rural areas 15 and on a large scale.…”

Section: Discussionmentioning

confidence: 99%

Single-lead ECGs (AliveCor) are a feasible, cost-effective and safer alternative to 12-lead ECGs in community diagnosis and monitoring of atrial fibrillation

et al. 2021

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BackgroundCommunity management of atrial fibrillation (AF) often requires the use of electrocardiographic (ECG) investigation. Patients discharged following treatment of AF with fast ventricular response (fast AF) can require numerous ECGs to monitor rate and/or rhythm control. Single-lead ECGs have been proposed as a more convenient and relatively accurate alternative to 12-lead ECGs for rate/rhythm management and also diagnosis of AF. We aimed to examine the feasibility of using the AliveCor single-lead ECG monitor for diagnosis and monitoring of AF in the community setting.MethodsDuring the course of 6 months, this evaluation of a clinical service improvement pathway used the AliveCor in management of patients requiring (1) follow-up ECGs for AF with previously documented rapid ventricular rate or (2) ECG confirmation of rhythm where AF was suspected. Twelve AliveCor devices provided to the acute community medical team were used to produce 30 s ECG rhythm strips (iECG) that were electronically sent to an overreading physician.ResultsSeventy-four patients (mean age 82 years) were managed on this pathway. (1) The AliveCor was successfully used to monitor the follow-up of 37 patients with fast AF, acquiring a combined total of 113 iECGs (median 1.5 ±3.75 per patient). None of these patients required a subsequent 12-lead ECG and this approach saved an estimate of up to £134.49 per patient. (2) Of 53 patients with abnormal pulses, the system helped identify 8 cases of new onset AF and 19 cases of previously known AF that had reverted from sinus back into AF.ConclusionsWe have demonstrated that the AliveCor system is a feasible, cost-effective, time-efficient and potentially safer alternative to serial 12-lead ECGs for community monitoring and diagnosis of AF.

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“…However, having more than one lead is often useful. For example, on occasion, it allows for the clearing up of doubts as to whether a lead is subject to artifacts (Figure 3 ) or to better assess the wave morphology, which is important on certain occasions[ 8 , 36 , 37 ].…”

Section: Electrocardographic Cardiac Monitoring Devicesmentioning

confidence: 99%

Cardiac monitoring for patients with palpitations

Francisco‐Pascual¹,

Cantalapiedra-Romero²,

Pérez-Rodón³

et al. 2021

WJC

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Palpitations are one of the most common reasons for medical consultation. They tend to worry patients and can affect their quality of life. They are often a symptom associated with cardiac rhythm disorders, although there are other etiologies. For diagnosis, it is essential to be able to reliably correlate the symptoms with an electrocardiographic record allowing the identification or ruling out of a possible rhythm disorder. However, reaching a diagnosis is not always simple, given that they tend to be transitory symptoms and the patient is frequently asymptomatic at the time of assessment. In recent years, electrocardiographic monitoring systems have incorporated many technical improvements that solve several of the 24-h Holter monitor limitations. The objective of this review is to provide an update on the different monitoring methods currently available, remarking their indications and limitations, to help healthcare professionals to appropriately select and use them in the work-up of patients with palpitations.

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Comparison of one- and three-lead ECG to measure cardiac intervals and differentiate drug-induced multi-channel block

Cited by 5 publications

References 12 publications

Confounders and Pharmacological Characterization When Using the QT, JTp, and Tpe Intervals in Beagle Dogs

Confounders and Pharmacological Characterization When Using the QT, JTp, and Tpe Intervals in Beagle Dogs

Single-lead ECGs (AliveCor) are a feasible, cost-effective and safer alternative to 12-lead ECGs in community diagnosis and monitoring of atrial fibrillation

Cardiac monitoring for patients with palpitations

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