Allied Professionals (Non-physician submissions only) -> Clinical Research D-AB01 - The Wide Spectrum of Arrhythmia Care: EP Procedure to Follow-up (ID 24) Abstract

D-AB01-01 - Optimization Of Surface Electrocardiogram Recording Quality In Patients With Continuous Flow Left Ventricular Assist Devices (ID 757)

 E.E. Flatley: Nothing relevant to disclose.


Background: Patients with continuous flow left ventricular assist devices (LVADs) have complex cardiovascular issues and frequently require a 12-lead electrocardiogram (EKG) for diagnostic purposes. Surface EKG recordings for these patients are often distorted by electromagnetic artifact from the LVAD.
Objective: We sought to determine EKG recording parameters and LVAD pump speed settings for minimization of artifact and optimization of surface EKG quality.
Methods: We collected and analyzed 12-lead EKGs in patients with continuous flow LVAD, with adjustment of recording filters and pump speeds. The MAC 5500 (General Electric, Boston, MA) was used for EKG collection, and post-processing filters were applied in the standard MUSE Cardiology Information System (General Electric, Boston, MA).
Results: High-frequency electromagnetic artifact was consistently reduced with adjustment of the low-pass display filter from the default value (100 or 150 Hz) to 40 Hz. For the HeartWare HVAD device, further improvement was achieved with higher pump speeds. Artifact was minimized using a low-pass filter of 20 Hz, but with loss of some previously noted fractionation in the QRS complex and attenuation of pacemaker artifact.
Conclusion: Electromagnetic artifact on the surface EKG can be significantly reduced for patients with the HVAD, Heartmate 2, and Heartmate 3 continuous flow LVAD devices using a simple adjustment in the low pass filter. Settings can be changed either on the recording device at the point of care, or after collection in the storage and interpretation system. If filter adjustments alone are insufficient, temporary adjustment in LVAD pump speeds may provide further optimization.