New Holter Monitoring Analysis System Synthesizing 12-Lead Electrocardiograms Using a Calculation of the Lead Vectors

• Published in: Circulation Journal Vol. 68; no. 8; pp. 751 - 756
• Main Authors: Nanke, Toshihiko, Nakazawa, Kiyoshi, Sakurai, Tsuneharu, Matsumoto, Naoki, Kishi, Ryouji, Takagi, Akihiko, Sato, Chuichi, Miyake, Fumihiko, Yamaki, Takashi, Kaneko, Mutsuo
• Format: Journal Article
• Language: English
• Published: The Japanese Circulation Society 2004
• Subjects: eVn leads; Frank's image surface; Holter monitoring; Lead vector; Synthesized 12-lead ECG
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.68.751

Background A new system of synthesizing a 12-lead electrocardiogram (Syn-ECG) with practically identical waveforms to the standard 12-lead ECG (Stn-ECG) from 3-channel ECGs recorded by Holter monitoring has been developed. Methods and Results The study group comprised 16 healthy individuals and 13 patients with abnormal ECGs. The bipolar eV1, eV5 and eVF leads were recorded using digital Holter monitoring and nine Syn-ECGs, corresponding to each lead of the Stn-ECG, were synthesized. The 9 ECGs consisted of a theoretical Syn-ECG and 8 Syn-ECGs positioned around the theoretical Syn-ECG at 3 cm intervals on the Frank's image surface. Of the 9 ECGs, the Syn-ECG with the maximum product of the cross-correlation coefficient of the QRS wave and that of the T wave, was automatically selected as the optimal Syn-ECG. The amplitude data from the QRS wave, R wave, T wave, and ST level, and also the amplitude ratio of the R wave, T wave to the QRS wave, were significantly well correlated between the Syn-ECG and Stn-ECG. Conclusions A practically identical ECG morphology, comparable with a Stn-ECG, was successfully created using this system. (Circ J 2004; 68: 751 - 756)