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Chapter-22 ECG—A New Method for Obtaining Better Recordings

BOOK TITLE: Practical Cardiology

Author
1. Khan M Gabriel
ISBN
9789386056016
DOI
10.5005/jp/books/18060_23
Edition
1/e
Publishing Year
2018
Pages
6
Author Affiliations
1. University of Ottawa; The Ottawa Hospital, Ottawa, Ontario, Canada
Chapter keywords
Electrocardiogram, ECG, limb movement, tremor, anxiety, particularly cold extremity, myocardial infarction, MI, distortion artifact

Abstract

The standard placement of electrodes on the wrist and ankles used successfully since approximately 1944 (Wilson et al. 1944) may produce poor quality electrocardiograms (ECGs). Limb movement, tremor, anxiety, particularly cold extremities and other factors cause distortion (artifacts) of the baseline and ECG waveforms leading to in accurate ECG interpretation and diagnostic delays. A few investigators in very small studies done between 1989 and 2005 have confirmed that placing the writs ankle electrodes on the chest and abdomen (torso placements, called modified leads) gives better quality ECG recordings but causes erroneous electrocardiography and should be used only in exceptional situations, example patients with severe tremor as in Parkinson’s.

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