Recommendations for the Standardization and Interpretation of the Electrocardiogram

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. Throughout the statement, recommendations for ECG standards are placed in context of the clinical implications of evolving ECG technology.

Electrocardiography Pitfalls and Artifacts: The 10 Commandments

“…The torso position induces a change in how the electrical vectors are recorded. Pseudo-Q waves and pseudo-STsegment elevation in the inferior leads 5,23,24 could potentially be misinterpreted as myocardial infarction (Figure 8). …”

A 64-Lead Body Surface Potential Mapping System

“…The digital filters' specifications follow standard international recommendations [9]. A second order Savitzky-Golay filter with cutoff frequency at 150 Hz is used to remove high frequency components [10].…”

A method to detect heart rate based on electrical bio-impedance

“…After we obtained the origin signal, we use a band-pass filter with cut-off frequencies is comprised of 0.7and40 Hz, and the filtercould effectively remove the baseline driftand the interference signal such as respiration-related low frequencynoise and50Hz power-line interference [10].R-peaks are found using the Pan-Tompkins algorithm [11] that is properly for this study due to its high accuracy, and the R-peaks location are used to compute the RR interval time series. Figure 3 shows the ECG and the EBI signal from one of the volunteers.…”