Reconstruction and Validation of the 12-Lead Electrocardiogram from 3-lead Patch-type Device

Abstract

The 12-lead electrocardiogram (ECG) is a vital diagnostic tool for cardiologists. A conventional 12-lead system is desirable to obtain full information from ECG, as different kinds of information can be obtained from different locations of leads. The standard 12-lead system requires 10 electrodes to be attached on a wide bare area of the human body. However, to be applied in a mobile system, a reduced number of electrodes is mandatory

in addition, lead positions should be close enough to be put in a patch system. For these reasons, we propose the 3-lead patch-type ECG device. With the signals obtained from the device, we synthesized 12-lead ECG by personal transformation and by universal transformation, equation that was established in 15 normal subjects. These reconstructed ECGs were compared with standard 12-lead ECG. Measurements of normal parameters in standard, personal and universal transformation ECG were compared in 10 normal subjects. The total QRS voltage in universal transformation was significantly lower than that in standard ECG (p<0.04). No statistically significant differences were observed among the normal parameters except in the case of the total QRS voltage. The diagnostic sensitivity and specificity of personalized and universal transformation ECG were tested in 38 patients with pathologic findings in ECG (LVH: 14, wide QRS (≥ 120 ms): 6, pathologic Q : 6, ST elevation : 7, ST depression : 10, T inversions: 9). Both personalized and universal transformation ECG are sensitive and specific in the detection of the alteration in the direction of electric vectors as pathologic Q and T inversions, but are insensitive in the detection of small changes in the magnitude of electric vectors as ST changes. Personalized and universal transformation ECG were sensitive in detecting wide QRS complex

however, there were false positive cases with specificity of 77% and 79%, respectively. Reconstruction of 12-lead ECG using a 3-lead patch-type device is feasible, valid in the measurements of normal parameters and can provide additional information compared to the single lead-ECG. However, further study is needed to increase the sensitivity of detecting ST changes and to overcome the problem of false positive wide QRS complexes.

Keyword: Patch-type device, synthesized ECG, Pathologic ECG