Intracardiac ECG and recognizing complex cardiac arrhythmias
Abstract:
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.
Reference:
Antezana-Chavez E, Papantoniou A, Waisten K, Rodriguez G, Hadid C, Di Toro D, Celano L, Lopez C, Labadet C, Gagliardi J. Usefulness of the intracardiac electrocardiogram recorded using central venous catheters on P-wave magnification. J Electrocardiol. 2023 Dec 19;82:141-146. doi: 10.1016/j.jelectrocard.2023.12.007. Epub ahead of print. PMID: 38141487.