AHA/ACC/HRS SCIENTIFIC STATEMENT
Recommendations for the Standardization and Interpretation of the ElectrocardiogramPart I: The Electrocardiogram and Its Technology A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society Endorsed by the International Society for Computerized Electrocardiology
Paul Kligfield, MD, FAHA, FACC,
Leonard S. Gettes, MD, FAHA, FACC,
James J. Bailey, MD,
Rory Childers, MD,
Barbara J. Deal, MD, FACC,
E. William Hancock, MD, FACC,
Gerard van Herpen, MD, PhD,
Jan A. Kors, PhD,
Peter Macfarlane, DSc,
David M. Mirvis, MD, FAHA,
Olle Pahlm, MD, PhD,
Pentti Rautaharju, MD, PhD and
Galen S. Wagner, MD
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Abstract
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This statement examines the relation of the resting ECG to its technology. Its purpose is to foster understanding of how the modern ECG is derived and displayed and to establish standards that will improve the accuracy and usefulness of the ECG in practice. Derivation of representative waveforms and measurements based on global intervals are described. Special emphasis is placed on digital signal acquisition and computer-based signal processing, which provide automated measurements that lead to computer-generated diagnostic statements. Lead placement, recording methods, and waveform presentation are reviewed. Throughout the statement, recommendations for ECG standards are placed in context of the clinical implications of evolving ECG technology.
Key Words: AHA Scientific Statements • electrocardiography • computers • diagnosis • electrophysiology • intervals • potentials • tests
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Footnotes
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Other members of the Standardization and Interpretation of the Electrocardiogram Writing Group include Mark Josephson, MD, FACC, FHRS; Jay W. Mason, MD, FAHA, FACC, FHRS; Peter Okin, MD, FACC; Borys Surawicz, MD, FAHA, FACC; and Hein Wellens, MD, FAHA, FACC.
The American Heart Association, the American College of Cardiology Foundation, and the Heart Rhythm Society make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.
This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on October 26, 2006, by the American College of Cardiology Board of Trustees on October 12, 2006, and by the Heart Rhythm Society on September 6, 2006.
When citing this document, the American Heart Association, the American College of Cardiology Foundation, and the Heart Rhythm Society request that the following citation format be used: Kligfield P, Gettes LS, Bailey JJ, Childers R, Deal BJ, Hancock EW, van Herpen G, Kors JA, Macfarlane P, Mirvis DM, Pahlm O, Rautaharju P, Wagner GS. Recommendations for the standardization and interpretation of the electrocardiogram: part I: the electrocardiogram and its technology: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. J Am Coll Cardiol 2007;49:1109–27.
This article has been copublished in the March 13, 2007, issue of Circulation and in the March 2007 issue of Heart Rhythm.
Copies: For copies of this document, please contact Elsevier Inc. Reprint Department, fax (212) 633-3820, e-mail reprints{at}elsevier.com.
Permissions: Modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml?Identifier=4431. A link to the "Permission Request Form" appears on the right side of the page.
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