The esophageal ECG as a novel technique for ambulant heart rhythm monitoring

Häberlin, A.; Niederhauser, T; Marisa, Thanks; Tanner, Hildegard; Götte, Josef; Jacomet, Marcel; Fuhrer, Jürg; Vogel, Rolf (2011). The esophageal ECG as a novel technique for ambulant heart rhythm monitoring. Journal of cardiovascular electrophysiology, 22(Suppl. 1), S162. Malden, Mass.: Wiley-Blackwell 10.1111/j.1540-8167.2011.02154.x

Introduction: Diagnosing arrhythmias by conventional Holter-ECG can be cumbersome because of artifacts, skin irritation and poor P-waves. In contrast, esophageal electrocardiography (eECG) is promising due to the anatomic relationship of the esophagus to the atria and its favorable bioelectric properties.
Methods used: In an ambulant setting, we recorded eECGs from 10 volunteers with a novel, highly-miniaturized eECG recorder that is worn discretely behind the ear (1.5×1.8×5cm, 22grams). The device continuously records two eECG leads during 3 days with 500Hz sampling frequency and 24-bit resolution.
Results: Mean ± SD recording time was 21.7±19.6 hours (max. 60 hours). Test persons were not limited in daily activities (e.g. eating, speaking) and only complained mild discomfort during probe insertion, which subsided later on. During 99.8% of time, the recorder acquired signals appropriate for further analysis. In unfiltered data, QRS complexes and P-waves were identifiable during >98% of time. P waves had higher amplitudes as compared to surface ECG (0.71 ± 0.42mV vs. 0.16 ± 0.03mV, p = 0.004). No complications occurred.
Conclusion: Ambulatory eECG recording is safe, well tolerated and promising due to excellent P-wave detection, overcoming some limitations of conventional Holter ECG.

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