Coefficients for the Derivation of Posterior and Right Sided Chest Leads From the 12-lead Electrocardiogram

Background: The 12-lead ECG is spatially limited in diagnosing cardiac abnormalities. Additional leads (right sided and posterior leads) are inconvenient in a clinical setting, however, they can be derived. In this paper we report on the development of coefficients to allow derivation of right sided and posterior leads. Method: Analysis was performed using body surface potential maps (BSPM) recorded from 910 patients in two centres. Recordings were made up of healthy controls (n=314), peak balloon inflation during elective percutaneous coronary angioplasty (n=88), myocardial infarction (n=271) and left-ventricular hypertrophy (n=237). All recordings were expanded to the 352-node Dalhousie torso. Coefficients to allow derivation of right sided and posterior leads were generated by linear regression. Further coefficients from a previously reported study were used for performance comparisons. Results: Correlation coefficients between recorded and derived leads were significantly improved using the new coefficients (p<0.05) in leads V7-V12. Conclusion: We have developed coefficients that allow the derivation of 10 additional leads from the 12-lead ECG.