Estimating the measuring sensitivity of unipolar and bipolar ECG with lead field method and FDM models.

New portable electrocardiogram (ECG) measurement systems are emerging into market. Some use nonstandard bipolar electrode montage and sometimes very small interelectrode distances to improve the usability of the system. Modeling could provide a straightforward method to test new electrode systems. The aim of this study was to assess whether modeling the electrodes' measuring sensitivity with lead field method can provide a simple tool for testing a number of new electrode locations. We evaluated whether the actual ECG signal strength can be estimated by lead fields with two realistic 3D finite difference method (FDM) thorax models. We compared the modeling results to clinical body surface potential map (BSPM) data from 236 normal patients and studied 117 unipolar and 42 bipolar leads. In the case of unipolar electrodes the modeled measuring sensitivities correlated well with the clinical data (r=0.86, N=117, p<0.05). In the case of bipolar electrodes the correlation was moderate (r=0.62 between Model 1 and clinical data, r=0.71 between Model 2 and clinical data, N=42 and p<0.05 for both). Based on this we can conclude that lead field analysis based on realistic thorax models provides a good initial prediction for designing new electrode montages and measurement systems.