As part of the International Electrotechnical Commission's (IEC) effor
ts to develop standards for interpretive electrocardiographs, electroc
ardiograms (ECGs of the Common Standards of Electrocardiography (CSE)
multilead measurement database were processed to (1) determine whether
original ECG data would offer any advantage over cycle-repeated (arti
ficial) ECGs and (2) compare the ''clean'' ECGs selected for interval
measurement compliance testing (n = 100) with the remaining 25 ''noisy
'' or nonsinus rhythm ECGs. Two sets of CSE measurement ECGs, namely,
125 original ECGs of the MO1 series and 125 artificial ECGs of the MA1
series were divided into 100 IEC-selected clean ECGs with good P and
T waves and 25 noisy or nonsinus ECGs and processed for global wave du
ration and interval measurements (P duration, PR interval, QRS duratio
n, and QT interval). The measured duration and interval values were co
mpared against the CSE reference values (medians of referee values for
25 physician overread ECGs and medians of interpretive programs for t
he rest) to compute the measurement ''differences.'' Also, the data of
the median cardiac complex were evaluated for noise content. The orig
inal ECG data gave consistently smaller differences for all of the fou
r measurements than the differences with the artificial ECG data. The
noise levels in the median complexes formed from the original ECG data
were significantly lower than the noise levels in the median complexe
s from the artificial ECG data. The noise levels in the medians of the
100 clean ECGs were lower than the noise levels in the medians of the
25 noisy ECGs for both the original and artificial ECG data.