Optimization of the Electrode Positions of Multichannel ECG for the Reconstruction of Ischemic Areas by Solving the Inverse Electrocardiographic Problem

Myocardial ischemia is one of the leading causes of morbidity and mortality in the western countries. It is of importance to efficiently and accurately detect and localize ischemia in the early stage. The solution of the inverse problem of electrocardiography provides a promising noninvasive approach for the localization of ischemic areas. However, the general electrode configuration of multichannel ECG utilized in the inverse problem is not optimized for this application. In the present investigation 153 ischemic areas of different sizes and at various sites in the entire left ventricle are simulated with a cellular automaton and the corresponding body surface potentials are computed using the finite element method. The body surface potential distributions in ST-interval of different myocardial ischemic areas are analyzed using singular value decomposition in order to determine the optimal electrode configuration of multichannel ECG for the reconstruction of ischemia by solving the inverse problem. The inverse problem is solved using the classical Tikhonov regularization and the maximum a posteriori based regularization. The reconstructions from the ECGs recorded by the optimized electrode configuration show significant improvement over those from the previous configuration.