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

The use of an esophageal catheter to check the results of left atrial posterior wall isolation in the treatment of atrial fibrillation

“…We propose a short procedure requiring fluoroscopy and a system analyzer for the esophageal electrode. A method exists to predict the level of the left atrium for esophageal pacing using patient height but a few seconds of fluoroscopy adds a greater accuracy to the procedure at minimal additional risk. Further study could increase the accuracy of using the esophageal catheters “blind” but we would currently recommend fluoroscopy in all cases.…”

Toward a novel semi‐invasive activation mapping tool for the diagnosis of supraventricular arrhythmias from the esophagus

“…Since the atrial signal amplitude is about seven times higher in the eECG compared to the sECG (Haeberlin, Niederhauser, et al, 2013), it may be an useful tool for the discrimination of supraventricular heart rhythm disorders (Haeberlin, Shakir, Vogel, & Tanner, 2013). Since the atrial signal amplitude is about seven times higher in the eECG compared to the sECG (Haeberlin, Niederhauser, et al, 2013), it may be an useful tool for the discrimination of supraventricular heart rhythm disorders (Haeberlin, Shakir, Vogel, & Tanner, 2013).…”

“…heel of standard 12-channel ECGs due to the low atrial signal quality, the amplitude of which is merely a 10%-20% of that of the ventricles and consequently often masked or heavily perturbed by either the QRS complex, the T wave, or artifacts. Since the atrial signal amplitude is about seven times higher in the eECG compared to the sECG (Haeberlin, Niederhauser, et al, 2013), it may be an useful tool for the discrimination of supraventricular heart rhythm disorders (Haeberlin, Shakir, Vogel, & Tanner, 2013). The presented two-dimensional isopotential maps are the first step toward a threedimensional mapping system from the esophagus view, which aim to allow simple bedside observational electrophysiological studies without invasive catheters.…”

“…On the forefront of the field are electrocardiographic imaging (ECGI) systems, which combine multi-electrode measurements from up to 252 body surface electrodes with patient-specific anatomical information from computed tomography (CT) imaging to reconstruct epicardial depolarization sequences (Rudy, 2013;Shah, Hocini, Xhaet, et al, 2013). Alternative approaches include measurements of the heart magnetic field (Ha, Kim, Lim, Yu, & Kwon, 2015;Kim, Kim, Lee, & Ahn, 2007;Sorbo et al, 2018), the exploitation of vectorcardiograms (Castells et al, 2011;Hasan, Abbott, & Baumert, 2012;Man, Maan, Schalij, & Swenne, 2015), or the acquisition of esophageal electrocardiograms (eECGs) (Haeberlin, Niederhauser, et al, 2013;Niederhauser et al, 2012). Esophageal ECGs have interesting properties, the most notable of which is an excellent atrial signal quality.…”

Fishing for P-waves during wide-complex tachycardia

“…After adenosine administration, the patient experienced dyspnoea and chest pain, which made her move her arms and resulted in poor signal quality of the rhythm strip. [3]. In general, atrial activity may also be unmasked on the standard ECG leads during adenosine administration.…”