Background

The detection of atrial electrical activity is extremely valuable in recognizing complex cardiac arrhythmias. However, P-wave detection on a surface electrocardiogram (S-ECG) can sometimes be challenging. The intracardiac electrocardiogram (IC-ECG), recorded by a central venous catheter loaded with saline solution, has proven to be a safe and effective method for amplifying atrial electrical activity. We aim to compare the P-wave amplitude recorded in the S-ECG and the IC-ECG in different venous accesses, catheters, heart rhythms, and atrial dimensions.

Methods

We compared the P wave amplitude obtained by the IC-ECG and the S-ECG recordings from cardiac intensive care unit patients.

Results

In 109 nonconsecutive patients, a total of 166 IC-ECG were collected. The median amplitude of the P wave was 0.1 (0.083–0.3) mV in the S-ECG and 0.4 (0.25–2.4) mV in the IC-ECG; p < 0.001. This difference remained significant regardless of the patient's heart rhythm, left atrial dimension, and catheter or vascular access used.

Conclusion

The IC-ECG acquired using central venous catheters significantly increases atrial electrical activity signals. This technique might help identify complex cardiac arrhythmias.

中文翻译：

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使用中心静脉导管在 P 波放大上记录心内心电图的有用性

背景

心房电活动的检测对于识别复杂的心律失常非常有价值。然而，表面心电图 (S-ECG) 上的 P 波检测有时可能具有挑战性。由装有盐溶液的中心静脉导管记录的心内心电图（IC-ECG）已被证明是放大心房电活动的安全有效的方法。我们的目的是比较不同静脉通路、导管、心律和心房尺寸下 S-ECG 和 IC-ECG 中记录的 P 波振幅。

方法

我们比较了心脏重症监护病房患者的 IC-ECG 和 S-ECG 记录获得的 P 波振幅。

结果

在 109 名非连续患者中，总共收集了 166 份 IC-ECG。S-ECG 中 P 波的中位振幅为 0.1（0.083-0.3）mV，IC-ECG 中 P 波中位振幅为 0.4（0.25-2.4）mV；p  < 0.001。无论患者的心律、左心房尺寸以及使用的导管或血管通路如何，这种差异仍然显着。

结论

使用中心静脉导管采集的 IC-ECG 显着增加心房电活动信号。这项技术可能有助于识别复杂的心律失常。