Optimal configuration of adhesive ECG patches suitable for long-term monitoring of a vectorcardiogram

The purpose of this study was to develop optimal configuration of adhesive ECG patches placement on the torso, which would provide the best agreement with the Frank orthogonal ECGs. Ten seconds of orthogonal ECG followed by 3–5 min of ECGs using patches at 5 different locations simultaneously on the torso were recorded in 50 participants at rest in sitting position. Median beat was generated for each ECG and 3 patch ECGs that best correlate with orthogonal ECGs were selected for each participant. For agreement analysis, spatial QRS-T angle, spatial QRS and T vector characteristics, spatial ventricular gradient, roundness, thickness and planarity of vectorcardiographic (VCG) loops were measured. Key VCG parameters showed high agreement in Bland–Altman analysis (spatial QRS-T angle on 3-patch ECG vs. Frank ECG bias 0.3 (95% limits of agreement [−6.23;5.71 degrees]), Lin's concordance coefficient = 0.996). In conclusion, newly developed orthogonal 3-patch ECG can be used for long-term VCG monitoring.