Evaluation of lead selection methods for optimal reconstruction of body surface potentials.

In this study, several methods for optimal lead selection from multilead electrocardiographic recordings are analyzed. Two different lead selection methods have been implemented. For their evaluation, a linear transformation that reconstructs nonselected leads from selected leads is computed according to the least squares optimization, and the performance is evaluated in terms of the mean square error of the derived potentials and correlation. The algorithms were tested on a database of 72 body surface potential recordings: 18 controls, 18 bundle-branch block, 18 myocardial infarction, and 18 ventricular hypertrophy. Each data set was divided into a study and test subsets. Two experiments were carried out: (1) The lead selection, transformation matrix, and performance evaluation is carried out over the test data set (ideal case), and (2) the lead selection and transformation matrix is carried out over the study data set, but the performance is evaluated over the test data set (real case). Our results show important reconstruction errors with either lead selection methods, and only increasing the number of leads reduces the error in reconstruction. However, if a reduced number of leads are to be selected outside the standard 12-lead electrocardiogram, the method proposed by Lux has been shown to be the best option.

[1]  R Hoekema,et al.  The Number of Independent Signals in Body Surface Maps , 1999, Methods of Information in Medicine.

[2]  I. Menown,et al.  Optimizing the initial 12-lead electrocardiographic diagnosis of acute myocardial infarction. , 2000, European heart journal.

[3]  J. Millet,et al.  Q wave myocardial intarction analysed by body surface potential mapping , 2004, Computers in Cardiology, 2004.

[4]  B Drew,et al.  Comparison of 18-lead ECG and selected body surface potential mapping leads in determining maximally deviated ST lead and efficacy in detecting acute myocardial ischemia during coronary occlusion. , 1999, Journal of electrocardiology.

[5]  A SippensGroenewegen,et al.  Body surface mapping during pacing at multiple sites in the human atrium: P-wave morphology of ectopic right atrial activation. , 1998, Circulation.

[6]  Robert L Lux Electrocardiographic potential correlations: rationale and basis for lead selection and ECG estimation. , 2002, Journal of electrocardiology.

[7]  R. Lux,et al.  Derivation of an optimal lead set for measuring ectopic atrial activation from the pulmonary veins by using body surface mapping. , 2000, Journal of electrocardiology.

[8]  I. Menown,et al.  Body surface mapping improves early diagnosis of acute myocardial infarction in patients with chest pain and left bundle branch block , 2003, Heart.

[9]  P Block,et al.  The Missing Waveform Information in the Orthogonal Electrocardiogram (Frank Leads): III. Computer Diagnosis of Angina Pectoris from “Maximal’ QRS Surface Waveform Information At Rest , 1974, Circulation.

[10]  Tohru Ohe,et al.  Usefulness of body surface mapping to differentiate patients with Brugada syndrome from patients with asymptomatic Brugada syndrome. , 2004, Acta medica Okayama.

[11]  I. Menown,et al.  Comparison of the 80-lead body surface map to physician and to 12-lead electrocardiogram in detection of acute myocardial infarction. , 2003, The American journal of cardiology.

[12]  Jan A. Kors,et al.  How many electrodes and where? A [ldquo ]poldermodel[rdquo ] for electrocardiography , 2002 .

[13]  Vincent Jacquemet,et al.  Vectorcardiographic lead systems for the characterization of atrial fibrillation. , 2007, Journal of electrocardiology.

[14]  Kazuhide Takeuchi,et al.  Utility of Right Precordial Leads at Higher Intercostal Space Positions to Diagnose Brugada Syndrome , 2002, Pacing and clinical electrophysiology : PACE.

[15]  Martin Borggrefe,et al.  Body surface potential mapping in patients with Brugada syndrome: right precordial ST segment variations and reverse changes in left precordial leads. , 2002, Cardiovascular research.

[16]  H. Morita,et al.  Evaluation of the usefulness of recording the ECG in the 3rd intercostal space and prevalence of Brugada-type ECG in accordance with recently established electrocardiographic criteria. , 2004, Circulation journal : official journal of the Japanese Circulation Society.

[17]  J. .. Abildskov,et al.  Clinically Practical Lead Systems for Improved Electrocardiography: Comparison with Precordial Grids and Conventional Lead Systems , 1979, Circulation.

[18]  F Kornreich,et al.  The Missing Waveform Information in the Orthogonal Electrocardiogram (Frank Leads): I. Where and How Can This Missing Waveform Information be Retrieved? , 1973, Circulation.

[19]  R. Macleod,et al.  Useful Lessons from Body Surface Mapping , 1998, Journal of cardiovascular electrophysiology.

[20]  P M Rautaharju,et al.  Qualitative and quantitative analysis of characteristic body surface potential map features in anterior and inferior myocardial infarction. , 1987, The American journal of cardiology.

[21]  Leif Sörnmo,et al.  Electroatriography - time-frequency analysis of atrial fibrillation from modified 12-lead ECG configurations for improved diagnosis and therapy. , 2007, Medical hypotheses.

[22]  F. Kornreich Identification of best electrocardiographic leads for diagnosing acute myocardial ischemia , 1998 .

[23]  David Moratal,et al.  Analysis of the extension of Q-waves after infarction with body surface map: relationship with infarct size. , 2006, International journal of cardiology.

[24]  J. A. Abildskov,et al.  Limited Lead Selection for Estimation of Body Surface Potential Maps in Electrocardiography , 1978, IEEE Transactions on Biomedical Engineering.

[25]  R L Lux,et al.  Electrocardiographic body surface potential mapping. , 1982, Critical reviews in biomedical engineering.

[26]  B. Sunsaneewitayakul,et al.  New electrocardiographic leads and the procainamide test for the detection of the Brugada sign in sudden unexplained death syndrome survivors and their relatives , 2001 .