Beat-by-beat recording of high resolution ECG: technical considerations

Nearly two decades ago, it was reported that non-invasive His-Purkinje potentials were recordable from the body surface utilizing temporal signal averaging1–3. The primary shortcoming of the technique is that this approach of signal averaging does not permit recording dynamic variations in the electrocardiogram (ECG) which may occur on a beat-by-beat basis. Attempts have been made since then by many investigators throughout the world to explore possible approaches to the recording and analysis of the microvolt level potentials on an every beat basis. The primary obstacle is the overwhelming interference such as instrumental noise, 60 Hz interference and electromyographic noise in which the signal of interest is buried. All the techniques that have been proposed are aimed at noise reduction. The most widely used method is spatial averaging4–10. This is a variation of averaging in which the ensemble of input is simultaneously from multiple surface leads rather than from sequential signals with a single lead. The technique has proved effective, although not optimal. Other techniques including finite element method11, matched filtering12, and adaptive filtering13 have been reported for beat-by-beat recording of His-Purkinje potentials.

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