Evaluation of limited and alternative lead sets for the reconstruction of the 12-Lead electrocardiogram and Body Surface Potential Maps

In this study we evaluate limited lead sets for the reconstruction of 12-lead ECGs and body surface potential maps (BSPMs). For 12-lead ECG reconstruction, we focused on four available limited lead systems (V₂, V₁V₅, V₁V₆, V₂V₅) to derive the standard 12-lead ECG and the EASI lead system as an alternative to the existing 12-lead ECG. We used a data set of 44 continuous 16-lead balloon inflation ECG registrations during percutaneous coronary interventions. For reconstruction of BSPMs an optimal lead selection algorithm was applied to a set of 744 BSPMs, consisting of recordings from subjects with myocardial infarction, left ventricular hypertrophy, and no apparent disease.Median root mean square (RMS) error for 12-lead ECG reconstruction were in decreasing order: V₁V₆: 165 muV, V2 131 muV, V1V5: 124 muV, EASI: 96 muV, and V2V5: 87 muV. In the BSPM reconstruction experiments, it was shown that by repositioning the six precordial leads the RMS error decreased from 35.4 muV to 26.7 muV. In summary, the results from this study have indicated that limited lead systems offer potential in all forms of cardiac monitoring and assessment, but certain lead sets show higher reconstruction errors.