Recognition of Electrocardiographic Left Arm/Left Leg Lead Reversal

Abdollah, Hoshiar; Milliken, John A.

doi:10.1016/s0002-9149(97)00656-5

Cited by 46 publications

(30 citation statements)

References 5 publications

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“…Lead switches affect 2 or more of the standard leads, thereby distorting the ECG recording. Limb lead switches can result in false-positive and false-negative signs of ischemia (138). Some of these changes can be recognized by an alert technician or correctly interpreted by the reviewing physician, particularly when previous ECGs are available, whereas others may go unrecognized or require repeat recording of the ECG (139).…”

Section: Discussionmentioning

confidence: 99%

Recommendations for the Standardization and Interpretation of the Electrocardiogram

Kligfield

Gettes²,

Bailey³

et al. 2007

Journal of the American College of Cardiology

575

140

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This statement examines the relation of the resting ECG to its technology. Its purpose is to foster understanding of how the modern ECG is derived and displayed and to establish standards that will improve the accuracy and usefulness of the ECG in practice. Derivation of representative waveforms and measurements based on global intervals are described. Special emphasis is placed on digital signal acquisition and computer-based signal processing, which provide automated measurements that lead to computer-generated diagnostic statements. Lead placement, recording methods, and waveform presentation are reviewed. Throughout the statement, recommendations for ECG standards are placed in context of the clinical implications of evolving ECG technology.

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Section: Discussionmentioning

confidence: 99%

Recommendations for the Standardization and Interpretation of the Electrocardiogram

Kligfield

Gettes²,

Bailey³

et al. 2007

Journal of the American College of Cardiology

575

140

View full text Add to dashboard Cite

show abstract

“…Método para cálculo da assimetria -Para a análise foram consideradas apenas as derivações I e II, pois a ocorrência de troca de eletrodos é mais facilmente visualizada em tais derivações [4]. Foi realizada uma filtragem passa-alta e passa baixa bidirecional (i.e., fase zero) utilizando filtros Butterworth de quarta ordem (frequência de corte 0.4 e 60 Hz respectivamente).…”

Section: Materiais E Métodosunclassified

“…No Brasil, uma das maiores realidades no setor é a Rede de Telessaúde de Minas Gerais [3], que gerencia e lauda diariamente mais de 2000 ECG coletados em mais de 600 municípios do estado de Minas Gerias. Um problema relativamente comum de qualidade do ECG detectado pelos analistas da Rede é a inversão no posicionamento dos eletrodos, e sua ocorrência pode resultar na impossibilidade de avaliar o exame ou em erros na interpretação do traçado [4]. O reconhecimento desse problema pode ser especialmente difícil quando o ECG é alterado pela presença de patologias [5].…”

Section: Introductionunclassified

Método Para Detecção Automática De Inversão De Eletrodos Em Eletrocardiogramas

Amaral¹,

Melo²,

Gomes³

et al. 2018

Anais Do v Congresso Brasileiro De Eletromiografia E Cinesiologia E X Simpósio De Engenharia Biomédica

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Resumo: A ocorrência de troca no posicionamento dos eletrodos em um exame de eletrocardiograma (ECG) pode levar ao erro ou impossibilidade de diagnóstico. Esse problema apresenta maior impacto no cenário de Telemedicina, onde a distância entre a fase de aquisição e a análise das informações é um fator crítico, gerando assim, perdas financeiras e sociais pois o paciente deverá se submeter novamente à etapa de coleta de dados. Este trabalho apresenta um método para a detecção automática de inversão de eletrodos em ECGs, baseado na quantificação da assimetria da distribuição de probabilidade do sinal de ECG. A performance do algoritmo foi avaliada através de análise estatística utilizando conceitos de sensitividade, especificidade e erros de falsos positivos e falsos negativos. O método foi testado em uma base de dados fornecida pela Rede de Telessaúde de Minas Gerais contendo 6967 ECGs clínicos, previamente classificados como: descartados por interferência, descartados por inversão de eletrodos, saudáveis e patológicos. O algoritmo proposto apresenta alto índice de detecção (95%) enquanto limita a quantidade de falsos positivos (<10%). Além disso, possui baixo custo computacional, o que viabiliza sua aplicação prática.Palavras-chave: ECG, inversão de eletrodos, detecção automática, assimetria. Abstract: The occurrence of electrode inversion in an electrocardiogram (ECG) examination can lead to errors in or impossibility of diagnosis. This problem has a greater impact in the Telemedicine

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“…Limb lead switches can result in false-positive and false-negative signs of ischemia. 138 Some of these changes can be recognized by an alert technician or correctly interpreted by the reviewing physician, particularly when previous ECGs are available, whereas others may go unrecognized or require repeat recording of the ECG. 139 Transposition of the left and…”

Section: Technologymentioning

confidence: 99%

“…Transposition of the right arm and right leg lead wires is also easy to recognize, because lead II now records the nearly zero potential difference that exists between the 2 legs, 140,141 which results in very low amplitude only in lead II, with inverted symmetry between standard lead I and lead III. Transposition of the left arm and left leg lead wires is more difficult to recognize because the main effects are an often subtle shift in axis and inversion of lead III; it can be suspected from changes in P-wave morphology in the limb leads, 138 although the specificity of this approach has been challenged. 137 Suspected lead switches may be confirmed by reference to a prior or subsequent tracing with correct lead placement.…”

Section: Kligfield Et Al Standardization and Interpretation Of The Ecmentioning

confidence: 99%

Recommendations for the Standardization and Interpretation of the Electrocardiogram

Kligfield¹,

Gettes²,

Bailey³

et al. 2007

Circulation

515

152

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Abstract-This statement examines the relation of the resting ECG to its technology. Its purpose is to foster understanding of how the modern ECG is derived and displayed and to establish standards that will improve the accuracy and usefulness of the ECG in practice. Derivation of representative waveforms and measurements based on global intervals are described. Special emphasis is placed on digital signal acquisition and computer-based signal processing, which provide automated measurements that lead to computer-generated diagnostic statements. Lead placement, recording methods, and waveform presentation are reviewed. Key Words: AHA Scientific Statements Ⅲ electrocardiography Ⅲ computers Ⅲ diagnosis Ⅲ electrophysiology Ⅲ intervals Ⅲ potentials Ⅲ tests I n the century since the introduction of the string galvanometer by Willem Einthoven, 1 the electrocardiogram (ECG) has become the most commonly conducted cardiovascular diagnostic procedure and a fundamental tool of clinical practice. 2,3 It is indispensable for the diagnosis and prompt initiation of therapy in patients with acute coronary syndromes and is the most accurate means of diagnosing intraventricular conduction disturbances and arrhythmias. Its interpretation may lead to the recognition of electrolyte abnormalities, particularly of serum potassium and calcium, and permit the detection of some forms of genetically mediated electrical or structural cardiac abnormalities. The ECG is routinely used to monitor patients treated with antiarrhythmic and other drugs, in the preoperative assessment of patients undergoing noncardiac surgery, and in screening individuals in high-risk occupations and, in some The American Heart Association, the American College of Cardiology, and the Heart Rhythm Society make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest. Copies: This document is available on the World Wide Web sites of the American Heart Association (www.americanheart.org) and the American College of Cardiology (www.acc.org). A single reprint is available by calling 800-242-8721 (US only) or writing the American Heart Association, Public Information, 7272 Greenville Ave, Dallas, TX 75231-4596. Ask for reprint No. 71-0389. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml? Identifierϭ4431. A link to the "Permission Request Form" appears on the right side of the page.© 2007 American...

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Recognition of Electrocardiographic Left Arm/Left Leg Lead Reversal

Cited by 46 publications

References 5 publications

Recommendations for the Standardization and Interpretation of the Electrocardiogram

Recommendations for the Standardization and Interpretation of the Electrocardiogram

Método Para Detecção Automática De Inversão De Eletrodos Em Eletrocardiogramas

Recommendations for the Standardization and Interpretation of the Electrocardiogram

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