Wrist and Arm Body Surface Bipolar ECG Leads Signal and Sensor Study for Long-term Rhythm Monitoring

With cardiovascular disease and heart arrhythmias continuing to have a high mortality rate, it is important to monitor the electrocardiogram (ECG) signal in a noninvasive, long-term wearable device. In this study we investigate sensors and the ECG signal-to-noise ratio map along the left arm, for wearable arm-ECG monitoring devices. In a pilot study, 11 subjects attending a cardiology outpatient clinic, far-field left-arm ECG recordings included signals from a combination of dry and special pre-gelled BIS-QuatroTM sensor system, axially and transversally oriented along the left arm: on the wrist, upper forearm and upper arm. A total of 10 bipolar leads were recorded simultaneously (using 18 acquisition channels). Each subject was recorded for 8 minutes at rest, using the bio-potential acquisition system; all data was imported and processed using Matlab and MS Excel. Analysis was completed to evaluate signal-to-noise ratio (SNR) distribution maps. An average ECG SNR figure of 42.63 was found in the dry-electrode positioned on the upper arm bipolar lead, whilst the SNR ratio positioned on the wrist was 13.14. Similar to this, in the BIS-electrodes (gelled), there was an average ECG SNR figure of 89.25 on the upper arm and of 5.18 positioned on the wrist. This study clinically evidenced the ECG S/N map on the left arm. It reveals that bipolar arm-ECG SNR are consistently stronger on the upper arm, when recorded with the gelled BIS sensors.