Assessment of signal quality measured with a smart 12-lead ECG acquisition T-shirt

Background Ambulatory ECG monitoring is typically achieved using portable devices with limited number of surface leads, autonomy, and length of recording. Smart garments with multiple conductive textile electrodes provide great promise to perform continuous and comfortable ECG monitoring. Methods We evaluated the ECG signal quality measured on healthy subjects with a smart 12-lead ECG acquisition T-shirt or a 12-lead Holter recording. ECG signals were recorded during 3 min with both techniques in three resting positions (supine, seated, standing) and while walking. Three readers independently assessed ECG patterns and evaluated the denoising of the isoelectric line, the distinction of p waves, R peaks and RR intervals, and the possible appreciation of cardiac rhythm in at least 3 leads. Results Thirty healthy subjects (70% males, 29.5 +/- 7.8 years) were enrolled in the study. For all three resting conditions, cardiac rhythm was appreciated in 100% of recordings with distinction of p waves, R peaks, and isoelectric line in >97% of recordings. Appreciation of cardiac rhythm was lower in the walking conditions with both techniques (53.3% vs. 46.7%, Holter vs. smart T-shirt, p = .60) mainly due to difficulties to distinguish p waves. These results were consistent across both genders. All ECG parameters (heart rate, PR, QRS and QTC intervals) were comparable between both techniques. No skin irritation was seen with the textile electrodes. Conclusions A smart T-shirt with 13 textiles electrodes allows short-duration 12-lead ECG acquisition with quality levels comparable to Holter recordings. The novel device should now be evaluated for long-term non-invasive ECG monitoring.