The optimal lead insertion depth for esophageal ECG recordings with respect to atrial signal quality

Häberlin, Andreas; Niederhauser, Thomas; Marisa, Thanks; Götte, Josef; Jacoment, Marcel; Mattle, Daniel; Roten, Laurent; Fuhrer, Jürg; Tanner, Hildegard; Vogel, Rolf (2013). The optimal lead insertion depth for esophageal ECG recordings with respect to atrial signal quality. Journal of electrocardiology, 46(2), pp. 158-165. Elsevier 10.1016/j.jelectrocard.2012.12.004

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Diagnosing supraventricular arrhythmias by conventional long-term ECG can be cumbersome because of poor p-waves. Esophageal long-term electrocardiography (eECG) has an excellent sensitivity for atrial signals and may overcome this limitation. However, the optimal lead insertion depth (OLID) is not known.


We registered eECGs at different lead insertion depths in 27 patients and analyzed 199,716 atrial complexes with respect to signal amplitude and slope. Correlation and regression analyses were used to find a criterion for OLID.


Atrial signal amplitudes and slopes significantly depend on lead insertion depth. OLID correlates with body height (rSpearman=0.71) and can be estimated by OLID [cm]=0.25*body height[cm]-7cm. At this insertion depth, we recorded the largest esophageal atrial signal amplitudes (1.27±0.86mV), which were much larger compared to conventional surface lead II (0.19±0.10mV, p<0.0001).


The OLID depends on body height and can be calculated by a simple regression formula.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Anatomy
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Cardiovascular Engineering (CVE)

UniBE Contributor:

Häberlin, Andreas David Heinrich, Niederhauser, Thomas, Marisa, Thanks, Götte, Josef, Mattle, Daniel, Roten, Laurent, Fuhrer, Jürg (A), Tanner, Hildegard, Vogel, Rolf


600 Technology > 610 Medicine & health








Hildegard Tanner

Date Deposited:

19 Mar 2014 14:30

Last Modified:

29 Mar 2023 23:33

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PubMed ID:


Uncontrolled Keywords:

Esophageal long-term electrocardiography; Optimal lead insertion depth; Body height


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