Optimal lead selection for the study of the P wave in sinus rhythm

Determination of the best electrode positioning for the study of the P wave would lead to a more accurate knowledge of atrial activity. Both Holter recordings and twelve lead electrocardiograms not always show the signal quality enough for a robust P wave detection. New leads could emphasize the P wave and provide more clearly information for the classification of arrhythmias or other atrial disorders. The best lead is defined such as the one presenting the highest amplitude and area in the whole body surface. 64 unipolar surface ECG signals were recorded form active electrodes covering the complete torso surface and 1860 bipolar computed. According their amplitude and area we could be make the conclusion that the best lead positioning for the study of the P wave has been found outside the standard twelve leads. The higher ratios have been found in leads combining recordings from an area close to the right collarbone and the area below left precordial zone