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An evaluation of the ensemble averaged impedance cardiogram.

The ensemble averaged impedance cardiogram was evaluated during rest and during vocal mental arithmetic stress in samples of female (n = 17) and male (n = 40) undergraduates. Measures of myocardial performance determined from ensemble averaged signals were compared to those determined by simple beat-to-beat averaging over 60-s and 20-s sampling intervals. In addition, the influence of cardiac interval variability on dZ/dt amplitude measures was assessed. As expected, measures derived by the two averaging techniques corresponded closely, with correlations ranging from r = 0.882 to r = 1.000 for the 60-s sampling intervals, and from r = 0.726 to r = 1.000 for the 20-s sampling intervals. Inverse relationships of comparable magnitude were found between cardiac interval variability and dZ/dt amplitude measures determined by both averaging techniques, suggesting that these relationships did not result simply from artifacts introduced by the ensemble averaging technique. The results support the validity of ensemble averaging as a method for deriving impedance cardiographic measures of myocardial performance.