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J Electrocardiol. 2012 Nov-Dec;45(6):604-8. doi: 10.1016/j.jelectrocard.2012.08.012. Epub 2012 Sep 28.

Estimation performance of a reduced lead system during continuous 12-lead ECG ST-segment monitoring.

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School of Computing and Mathematics and Computer Science Research Institute, University of Ulster, Belfast, UK.



Reduced lead systems utilizing patient-specific transformation weights have been reported to achieve superior estimates than those utilizing population-based transformation weights. We report upon the effects of ischemic-type electrocardiographic changes on the estimation performance of a reduced lead system when utilizing patient-specific transformation weights and population-based transformation weights.


A reduced lead system that used leads I, II, V2 and V5 to estimate leads V1, V3, V4, and V6 was investigated. Patient-specific transformation weights were developed on electrocardiograms containing no ischemic-type changes. Patient-specific and population-based transformations weights were assessed on 45 electrocardiograms with ischemic-type changes and 59 electrocardiograms without ischemic-type changes.


For patient-specific transformation weights the estimation performance measured as median root mean squared error values (no ischemic-type changes vs. ischemic-type changes) was found to be (V1, 27.5 μV vs. 95.8 μV, P<.001; V3, 33.9 µV vs. 65.2 µV, P<.001; V4, 24.8 μV vs. 62.0 μV, P<.001; V6, 11.7 μV vs. 51.5 μV, P<.001). The median magnitude of ST-amplitude difference 60 ms after the J-point between patient-specific estimated leads and actual recorded leads (no ischemic-type changes vs. ischemic-type changes) was found to be (V1, 18.9 μV vs. 61.4 μV, P<.001; V3, 14.3 μV vs. 61.1 μV, P<.001; V4, 9.7 μV vs. 61.3 μV, P<.001; V6, 5.9 μV vs. 46.0 μV, P<.001).


The estimation performance of patient-specific transformations weights can deteriorate when ischemic-type changes develop. Performance assessment of patient-specific transformation weights should be performed using electrocardiographic data that represent the monitoring situation for which the reduced lead system is targeted.

[Indexed for MEDLINE]

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