Accuracy of Signal-to-Noise in Novel Electrocardiogram Technology Versus Standard Electrocardiogram Technology: A...

Patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) require immediate acquisition of a 12-lead electrocardiogram (ECG) to support early diagnosis and clinical decision making. Acute coronary syndrome includes ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and unstable angina. However, symptoms consistent with ACS may also include arrhythmias, such as premature ventricular contractions, atrial fibrillation, or supraventricular tachycardia. Accurate and timely ECG interpretation is essential for prompt risk stratification and initiation of appropriate management of the detected arrhythmia. The diagnostic accuracy of the ECG is highly dependent on signal quality, particularly the signal-to-noise ratio and the presence of artifacts from patient movement and monitoring equipment. Poor signal fidelity may contribute to misinterpretation and false-positive coronary activation. This literature review examines studies published over the past 5 years that evaluate advancements in ECG electrode technology and artifact-reduction strategies, including algorithm-based approaches, relative to conventional ECG systems. A review of current best practices for skin electrode optimization is also summarized.