Gerard H Smith1, Dawie J Van den Heever1, Wayne Swart1. 1. Biomedical Engineering Research Group, Department of Mechanical and Mechatronic Engineering, Stellenbosch University, South Africa.
Abstract
BACKGROUND: The 12-lead electrocardiogram (ECG) is the gold-standard ECG method used by cardiologists. However, accurate electrode placement is difficult and time consuming, and can lead to incorrect interpretation. OBJECTIVES: The objective of this study was to accurately reconstruct a full 12-lead ECG from a reduced lead set. METHODS: Five-electrode placement was used to generate leads I, II, III, aVL, aVR, aVF and V2. These seven leads served as inputs to the focus time-delay neural network (FTDNN) which derived the remaining five precordial leads (V1, V3-V6). An online archived medical database containing 549 cases of ECG recordings was used to train, validate and test the FTDNN. RESULTS: After removing outliers, the reconstructed leads exhibited correlation values of between 0.8609 and 0.9678 as well as low root mean square error values of between 123 μV and 245 μV across all cases, for both healthy controls and cardiovascular disease subgroups except the bundle branch block disease subgroup. The results of the FTDNN method compared favourably to those of prior lead reconstruction methods. CONCLUSIONS: A standard 12-lead ECG was successfully reconstructed with high quantitative correlations from a reduced lead set using only five electrodes, of which four were placed on the limbs. Less reliance on precordial leads will aid in the reduction of electrode placement errors, ultimately improving ECG lead accuracy and reduce the number of cases that are incorrectly diagnosed.
BACKGROUND: The 12-lead electrocardiogram (ECG) is the gold-standard ECG method used by cardiologists. However, accurate electrode placement is difficult and time consuming, and can lead to incorrect interpretation. OBJECTIVES: The objective of this study was to accurately reconstruct a full 12-lead ECG from a reduced lead set. METHODS: Five-electrode placement was used to generate leads I, II, III, aVL, aVR, aVF and V2. These seven leads served as inputs to the focus time-delay neural network (FTDNN) which derived the remaining five precordial leads (V1, V3-V6). An online archived medical database containing 549 cases of ECG recordings was used to train, validate and test the FTDNN. RESULTS: After removing outliers, the reconstructed leads exhibited correlation values of between 0.8609 and 0.9678 as well as low root mean square error values of between 123 μV and 245 μV across all cases, for both healthy controls and cardiovascular disease subgroups except the bundle branch block disease subgroup. The results of the FTDNN method compared favourably to those of prior lead reconstruction methods. CONCLUSIONS: A standard 12-lead ECG was successfully reconstructed with high quantitative correlations from a reduced lead set using only five electrodes, of which four were placed on the limbs. Less reliance on precordial leads will aid in the reduction of electrode placement errors, ultimately improving ECG lead accuracy and reduce the number of cases that are incorrectly diagnosed.
Entities:
Keywords:
ECG; Electrocardiography; Focus time-delay neural network; Neural networks; Reconstruct 12-lead ECG; Reduced lead set ECG
Authors: Paul Kligfield; Leonard S Gettes; James J Bailey; Rory Childers; Barbara J Deal; E William Hancock; Gerard van Herpen; Jan A Kors; Peter Macfarlane; David M Mirvis; Olle Pahlm; Pentti Rautaharju; Galen S Wagner; Mark Josephson; Jay W Mason; Peter Okin; Borys Surawicz; Hein Wellens Journal: J Am Coll Cardiol Date: 2007-03-13 Impact factor: 24.094
Authors: Barbara J Drew; Elise D Dempsey; Tae H Joo; Claire E Sommargren; James P Glancy; Kent Benedict; Mitchell W Krucoff Journal: J Electrocardiol Date: 2004 Impact factor: 1.438