Nelwan S P, Kors J A, Meij S H
Thoraxcentre, University Hospital Rotterdam, The Netherlands.
J Electrocardiol. 2000;33 Suppl:163-6. doi: 10.1054/jelc.2000.20296.
It may not always be possible to record all precordial leads of the standard 12-lead electrocardiogram (ECG). Especially in monitoring situations, a minimal lead set from which the 12-lead ECG can be reconstructed, would be valuable. This article assesses how well missing precordial leads could be synthesized from the remaining leads of the 12-lead ECG. A total of 2,372 diagnostic 12-lead ECG recordings were obtained from subjects with chest pain suggestive for acute myocardial infarction. Representative average beats were computed from the digital 12-lead ECG recordings with our Modular ECG Analysis System. The recordings were divided into a learning set and a test set. We considered all lead sets with one or more precordial leads removed, but always including limb leads I and II. By using the learning set, general reconstruction coefficients were computed to synthesize the missing precordial leads to each lead set. Performance of the synthesis was assessed by cross correlation between the original and the reconstructed leads. Also, patient-specific reconstruction coefficients were derived for each ECG in the test set and correlations were determined. High correlation coefficients were found with both reconstruction techniques. For different sizes of lead sets, the best patient-specific reconstructions had higher correlation values than the general reconstructions. For example, when 2 precordial leads were excluded, the best patient-specific median correlation was 0.994 compared to 0.963 for the best general reconstruction correlation. General reconstruction allows synthesis of 2 or 3 excluded precordial leads in good approximation. When patient-specific reconstruction can be applied, a minimal lead set including the limb leads and only 2 precordial leads suffices.
记录标准12导联心电图（ECG）的所有胸前导联并非总是可行的。特别是在监测情况下，能够重建12导联ECG的最小导联集将很有价值。本文评估了从12导联ECG的其余导联合成缺失胸前导联的效果。从提示急性心肌梗死的胸痛患者中总共获得了2372份诊断性12导联ECG记录。使用我们的模块化ECG分析系统从数字12导联ECG记录中计算代表性平均心搏。记录被分为学习集和测试集。我们考虑了所有去除一个或多个胸前导联但始终包括肢体导联I和II的导联集。通过使用学习集，计算通用重建系数以将缺失的胸前导联合成为每个导联集。通过原始导联和重建导联之间的互相关来评估合成的性能。此外，为测试集中的每个ECG推导患者特异性重建系数并确定相关性。两种重建技术都发现了高相关系数。对于不同大小的导联集，最佳的患者特异性重建的相关值高于通用重建。例如，当排除2个胸前导联时，最佳的患者特异性中位数相关性为0.994，而最佳通用重建相关性为0.963。通用重建可以很好地近似合成2个或3个排除的胸前导联。当可以应用患者特异性重建时，包括肢体导联和仅2个胸前导联的最小导联集就足够了。
