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The 12-lead electrocardiogram in exercise testing. A misleading baseline?

J P Kleiner, W P Nelson, M J Boland

    Archives of Internal Medicine
    |October 1, 1978
    PubMed
    Summary

    The Mason-Likar electrocardiogram (ECG) lead system, while standard for exercise monitoring, may alter baseline readings compared to standard ECGs. These changes can affect the detection of prior heart attacks, making it not interchangeable with standard ECGs.

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    Area of Science:

    • Cardiology
    • Medical Devices
    • Diagnostic Tools

    Background:

    • The Mason-Likar electrocardiogram (ECG) lead system is widely adopted for exercise stress testing.
    • It aims to minimize motion artifact during physical exertion.
    • This system is considered a benchmark for evaluating other exercise ECG methodologies.

    Purpose of the Study:

    • To compare baseline exercise ECGs obtained with the Mason-Likar modification against simultaneous standard ECGs.
    • To assess potential discrepancies in recorded lead configurations and their clinical implications.
    • To determine if the Mason-Likar system is interchangeable with standard ECGs for baseline assessment.

    Main Methods:

    • Simultaneous recording of 12-lead ECGs using both the Mason-Likar modified system and a standard ECG setup.

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  • Comparison of baseline ECG tracings obtained during exercise stress tests.
  • Analysis of potential differences in lead configuration and artifact reduction.

    • Main Results:

    • Significant differences were observed between baseline exercise ECGs from the Mason-Likar system and simultaneous standard ECGs.
    • These differences did not appear to impact the overall interpretation of the exercise stress test.
    • However, the observed changes could potentially create or mask evidence of antecedent myocardial infarction on the baseline ECG.

    Conclusions:

    • The Mason-Likar ECG lead system, despite its advantages in artifact reduction, is not interchangeable with standard ECGs for baseline assessment.
    • Clinicians should be aware of potential alterations in baseline ECGs when using the Mason-Likar system.
    • These alterations may affect the accurate detection of prior infarction, necessitating careful comparison with standard ECGs.