Reconstruction of the standard 12-lead ECG from recordings using nonstandard activity-compatible proximal limb lead positions

Abstract Proximal or torso placement of limb leads in the 12-lead electrocardiogram (ECG) has been shown to influence the appearance of QRS waveforms considerably. A method was developed for computer-based reconstruction of standard-like waveforms from nonstandard torso-recorded waveforms. Reconstruction coefficients required by the method were determined using ECG data obtained from 30 patients. The coefficients were then applied on an independent test set of 100 patients. In 21 of these patients, a second standard EGG was obtained the next day to determine the day-to-day variation in QRS waveforms. R wave amplitudes in leads I and II, and electrical axes in the frontal plane were measured in the standard ECG, the nonstandard ECG, and the reconstructed ECG. It is shown that the reconstruction method yields ECGs that differ less from standard than do two standard ECGs recorded on consecutive days. The performance of the reconstruction method was not influenced by age, sex, height, or weight.