Improved spatial sampling of ECG potentials on the body surface by repositioning electrodes from the standard 12-lead ECG

We propose a simple, practical approach to increase the diagnostic information content of the standard 12-lead ECG by repositioning selected chest leads. We used a set of 746 120-lead body-surface potential maps (BSPMs). Coefficients to reconstruct all BSPM leads from the standard ECG were derived by linear regression. Similarly, BSPMs were reconstructed when two of the leads V3-V6 were replaced by electrodes at other positions on the anterior part of the thorax. Repositioning lead V4 at two intercostal spaces below V2 and lead V6 at two intercostal spaces above V2 or at three intercostal spaces above V4 showed increased reconstruction performance as compared with the standard electrode positions in most parts of the anterior thorax, including regions that are known to contain important diagnostic information that is less well represented by the standard ECG. Also, this approach obviates the need to determine the precise location of V4, which may be difficult in women.