Critical review of electrocardiography measurement systems and technology

Abstract

Electrocardiography (ECG) is widely used in clinical practice, for example to diagnose coronary artery disease or the cause of chest pain during a stress test, while the patient is running on a treadmill. Ambulatory ECG monitoring is used for long term recording of ECG signals, while the patient carries out his/her daily activities. Artefacts in ECG are caused by the patient’s movement, moving cables, interference from outside sources, electromyography (EMG) interference and electrical contact from elsewhere on the body. Most of these artefacts can be minimized by using proper electrode design and ECG circuitry. However, artefacts due to subject’s movement are hard to identify and eliminate and can be easily mistaken for symptoms of arrhythmia and the physiological effects of exercise, leading to misdiagnosis and false alarms. This study provides an overview of various ambulatory ECG measurement systems and electrode topologies used for ECG sensing. The challenges associated with ambulatory ECG monitoring and the techniques used to overcome those challenges have also been discussed in this paper.

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