Vella Elumalai Dhandapani

Government General Hospital

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G. V. Uma

Anna University, Chennai

S. Venkatesan

Meenakshi Mission Hospital and Research Centre

M. Umapathy

National Institute of Technology Tiruchirappalli

J. Sivaraman

National Institute of Technology Rourkela

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National Institute of Technology Tiruchirappalli

Marymount University

Anna University, Chennai

University of Sydney

Meenakshi Mission Hospital and Research Centre

Madras Medical College

Government General Hospital

Institute of Cardiology

Dr. Kamakshi Memorial Hospital

Madurai Medical College

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Normal limits of ECG measurements related to atrial activity using a modified limb lead system

Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology (2014)

J. Sivaraman G. V. Uma S. Venkatesan M. Umapathy Vella Elumalai Dhandapani

Objective: The present study was designed to derive the normal limits of a new ECG lead system aimed at enhancing the amplitude of atrial potentials through the use of bipolar chest leads.Methods: Sixty healthy male subjects, mean age 38.85±8.76 years (range 25 to 58 years) were included in this study.In addition to a standard 12-lead ECG, a modified limb lead (MLL) ECG was recorded for 60 sec with the RA electrode placed in the 3 rd right intercostal space slightly to the left of the mid-clavicular line, the LA electrode placed in the 5 th right intercostal space slightly to the right of the mid-clavicular line and the LL electrode placed in the 5 th right intercostal space on the mid-clavicular line.Results: In the frontal plane, the modification of limb electrode positions produced significant changes compared to standard limb lead I and II.The mean P wave amplitude was 111±17μV in MLL I and 64±16μV in standard limb lead (SLL) I (p<0.001).Similarly it was 118±22μV in MLL II and 100±27μV in SLL II.No statistically significant changes were seen in V 1 -V 6 due to modification of the Wilson central terminal electrode positions. Conclusion:The modification of limb electrode placement leads to changes in the amplitude of the P waves in the MLL leads I and II compared to SLL leads I and II in healthy subjects.These changes may be of importance in the detection of atrial electrical activity.

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Intercostal space

10.5152/akd.2014.5155

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