JOURNAL ARTICLE

On designing and testing transformations for derivation of standard 12-lead/18-lead electrocardiograms and vectorcardiograms from reduced sets of predictor leads

B Milan Horácek, James W Warren, John J Wang
Journal of Electrocardiology 2008, 41 (3): 220-9
18433613
The aim of this study was to develop and evaluate transformation coefficients for deriving the standard 12-lead electrocardiogram (ECG), 18-lead ECG (with additional leads V7, V8, V9, V3R, V4R, V5R), and Frank vectorcardiogram (VCG) from reduced lead sets using 3 "limb" electrodes at Mason-Likar torso sites combined with 2 chest electrodes at precordial sites V1 to V6; 15 such lead sets exist and each can be recorded with 6-wire cable. As a study population, we used Dalhousie Superset (n = 892) that includes healthy subjects, postinfarction patients, and patients with a history of ventricular tachycardia. For each subject, 120-lead ECG recordings of 15-second duration were averaged, and all samples of the QRST complex for leads of interest were extracted; these data were used to derive--by regression analysis--general and patient-specific coefficients for lead transformations. These coefficients were then used to predict 12-lead/18-lead ECG sets and 3-lead VCG from 15 reduced lead sets, and the success of these predictions was assessed by 3 goodness-of-fit measures applied to the entire QRST waveform and to the ST deviation at J point; these 3 measures were similarity coefficient (SC in percentage), relative error (in percentage), and RMS error (in microvolts). Our results show that the best pair for predicting the standard 12-lead ECG by either general coefficients (mean SC = 95.56) or patient-specific coefficients (mean SC = 99.11) is V2 and V4; the best pair for deriving the 18-lead set by general coefficients (mean SC = 93.74) or by patient-specific coefficients (mean SC = 98.71) is V1 and V4; the best pair for deriving the Frank X, Y, Z leads is V1 and V3 for general coefficients (mean SC = 95.76) and V3 and V6 for patient-specific coefficients (mean SC = 99.05). The differences in mean SC among the first 8 to 10 predictor sets in each ranking table are within 1% of the highest SC value. Thus, in conclusion, there are several near-equivalent choices of reduced lead set using 6-wire cable that offer a good prediction of 12-lead/18-lead ECG and VCG; a pair most appropriate for the clinical application can be selected.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
18433613
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"