Electronic-textile 12-lead equivalent diagnostic electrocardiogram based on the EASI lead placement

Background: The standard 12-lead Holter ambulatory ECG monitor is complex in construction and uncomfortable for the wearer. A 12-lead equivalent ECG monitor was developed based on the EASI configuration with electronic-textile electrodes to meet these needs. Objective: In this study, we evaluated the accuracy and reliability of the EASI 12-lead equivalent ECG prototype. Results: The ECG hardware reproduced cardiac abnormalities from a ProSim 3.0 Vital signal simulator without significant deviation from a reference C.P. 200™ 12-Lead resting ECG. The vest and textile electrodes were subjected to 10 washing cycles. The joint connecting the snap fastener and the integrated wires were the weakest points, starting to fail after eight washing cycles; however, ten cycles of washing did not produce a noticeable loss of signal quality. The compression pressure for a stable-skin electrode interface of the vest was experimentally determined to be 15.92mmHg (minimum compression pressure at the 'I' electrode position) and 29.45mmHg (maximum compression pressure at 'E' electrode position). Conclusion: The textile-based ECG smart vest was non-inferior to standard 12-lead resting ECG and could be an alternative solution to monitor patients outside of a hospital setting, pending a larger scale trial with a clinical population.