Synthesis of the 12-Lead Electrocardiogram From Differential Leads

A new approach is proposed for synthesizing the standard 12-lead ECG from three differential leads formed by pairs of proximal electrodes on the body surface. The method is supported by a statistical analysis that gives the best personalized positions of electrodes. The measurements from multichannel ECGs were used to calculate the differential leads. Our algorithm searches for optimal differential leads and the corresponding personalized transformation matrix that is used to synthesize the standard 12-lead ECG. The algorithm has been evaluated on 99 multichannel ECGs measured on 30 healthy subjects and 35 patients scheduled for elective cardiac surgery. It is shown that the algorithm significantly outperforms the synthesis based on the EASI lead system with medians of correlation coefficients greater than 0.954 for all 12 standard leads. To determine the optimal number of differential leads, the syntheses for two, three, and four differential leads were calculated. The analysis shows that 3 is the optimal number of differential leads for practical applications. Because of the proximity of the differential electrodes, the proposed approach offers an opportunity for the synthesis of a standard 12-lead ECG with wireless electrodes.

[1]  V. Avbelj,et al.  Beat-to-beat repolarisation variability in body surface electrocardiograms , 2003, Medical and Biological Engineering and Computing.

[2]  D Kilpatrick,et al.  Vectorcardiographic features of ventricular extrasystoles correlated with conventional scalar electrocardiographic interpretation. , 1978, British heart journal.

[3]  Roman Trobec,et al.  Multivariate Linear Regression based Synthesis of 12-lead ECG from Three Bipolar Leads , 2010, HEALTHINF.

[4]  A. J. Pullan,et al.  The Forward Problem of Electrocardiography , 2010 .

[5]  Roman Trobec,et al.  Multichannel ECG measurement system , 1997, Proceedings of Computer Based Medical Systems.

[6]  Ljupco Hadzievski,et al.  A novel mobile transtelephonic system with synthesized 12-lead ECG , 2004, IEEE Transactions on Information Technology in Biomedicine.

[7]  G E Dower,et al.  Deriving the 12-lead electrocardiogram from four (EASI) electrodes. , 1988, Journal of electrocardiology.

[8]  Jari Hyttinen,et al.  Best Electrode Locations for a Small Bipolar ECG Device: Signal Strength Analysis of Clinical Data , 2008, Annals of Biomedical Engineering.

[9]  N. Draper,et al.  Applied Regression Analysis: Draper/Applied Regression Analysis , 1998 .

[10]  Tohru Sawanobori,et al.  Moving dipole analysis of normal and abnormal ventricular activation by magnetocardiography. , 2002, Journal of electrocardiology.

[11]  Chris D Nugent,et al.  Lead selection: old and new methods for locating the most electrocardiogram information. , 2008, Journal of electrocardiology.

[12]  V. Avbelj,et al.  Wireless network of bipolar body electrodes , 2010, 2010 Seventh International Conference on Wireless On-demand Network Systems and Services (WONS).

[13]  P. Rubel,et al.  A neural network approach for patient-specific 12-lead ECG synthesis in patient monitoring environments , 2004, Computers in Cardiology, 2004.

[14]  P Rubel,et al.  Quantitative assessment of eight different methods for synthesizing Frank VCGs from simultaneously recorded standard ECG leads. , 1992, Journal of electrocardiology.

[15]  Chris D. Nugent,et al.  Eigenleads: ECG Leads for Maximizing Information Capture and Improving SNR , 2010, IEEE Transactions on Information Technology in Biomedicine.

[16]  Jaakko Malmivuo,et al.  Optimizing bipolar electrode location for wireless ECG measurement - analysis of ECG signal strength and deviation between individuals , 2005 .

[17]  Mario Trottini,et al.  Day-to-day variability of electrocardiographic diagnosis of left ventricular hypertrophy in hypertensive patients. Influence of electrode placement , 2006, Journal of cardiovascular medicine.

[18]  Roman Trobec,et al.  Beat-to-beat QT interval variability before and after cardiac surgery , 2003, Comput. Biol. Medicine.

[19]  Emil Valchinov,et al.  Wearable Wireless Biopotential Electrode for ECG Monitoring , 2007 .

[20]  Roman Trobec Computer analysis of multichannel ECG , 2003, Comput. Biol. Medicine.

[21]  Stefan P Nelwan,et al.  Reconstruction of the 12-lead electrocardiogram from reduced lead sets. , 2004, Journal of electrocardiology.

[22]  Philip de Chazal,et al.  Automatic classification of heartbeats using ECG morphology and heartbeat interval features , 2004, IEEE Transactions on Biomedical Engineering.

[23]  Chris D Nugent,et al.  Synthesising the 12-lead electrocardiogram: Trends and challenges. , 2007, European journal of internal medicine.

[24]  Dirk Q Feild,et al.  Statistical and deterministic approaches to designing transformations of electrocardiographic leads. , 2002, Journal of electrocardiology.

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

[26]  Fabrice Axisa,et al.  Flexible technologies and smart clothing for citizen medicine, home healthcare, and disease prevention , 2005, IEEE Transactions on Information Technology in Biomedicine.

[27]  Dirk Q Feild,et al.  Improved EASI coefficients: their derivation, values, and performance. , 2002, Journal of electrocardiology.

[28]  C H Lorenz,et al.  Performance of QRS detection for cardiac magnetic resonance imaging with a novel vectorcardiographic triggering method , 2000, Journal of magnetic resonance imaging : JMRI.

[29]  Leo K. Cheng,et al.  The inverse problem of electrocardiography , 2011 .

[30]  R. Macleod,et al.  The Forward Problem of Electrocardiography , 2010 .

[31]  E. Frank An Accurate, Clinically Practical System For Spatial Vectorcardiography , 1956, Circulation.