Detection of electrode interchange in right precordial and posterior ECG leads

This study presents a method for automated detection of misplaced supplementary precordial leads, including the right-sided V3R, V4R and the posterior V8, V9 leads. Considering their uncommon use in clinical routine, a lead reversal is quite probable and could result in erroneous diagnosis and treat...

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Bibliographic Details
Main Authors: Jekova, I., Krasteva, V., Leber, R., Schmid, R., Abacherli, R.
Format: Conference Proceeding
Language:English
Subjects:
Area measurement
Automation
Cardiology
Computation
Electrocardiography
Electrodes
Lead
Medical services
Patients
Waveforms
Online Access:Request full text
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Summary:This study presents a method for automated detection of misplaced supplementary precordial leads, including the right-sided V3R, V4R and the posterior V8, V9 leads. Considering their uncommon use in clinical routine, a lead reversal is quite probable and could result in erroneous diagnosis and treatment. The method allows real-time implementation by scoring inter-lead cross-correlations over continuous 4s episodes, scanning the normal progression of PQRST waveforms within leads [V4R, V3R, V3, V4] and [V4, V5, V6, V8, V9]. A large 16-lead ECG database with 1333 chest pain patients is used to test the performance of the method for all possible 23 swaps between the supplementary leads V4R, V3R, V8, V9, assuming correct positions of the standard V1-V6. The sensitivity (Se) for lead reversals is Se=94.1±4.6%, ranged between 78.5% and 97.8%, with the most difficult detection of V3R/V4R swap (Se=78.5%), V4R/V9 swap (Se=83.7%), V8/V9 swap (Se=91.8%). The achieved specificity for the correct lead positions is Sp=83.4%.
ISSN:2325-8861
2325-887X
DOI:10.1109/CIC.2015.7411119