Accurate Reconstruction of the 12-Lead Electrocardiogram From a 3-Lead Electrocardiogram Measured by a Mobile Device

Clinical outcomes of several acute conditions, including myocardial infarction (MI), the most common cause of death, can be improved by timely diagnostics based on electrocardiography (ECG). However, current diagnostic technologies include a large number of wired ECG electrodes, which require accurate placement by trained personnel. The ideal ECG device would be suitable for self-measurement, i.e., would have a small number of electrodes, be mobile or portable, and provide an accurate diagnosis. However, these aims have not been met using the same device. A recently developed handheld ECG device with three quasi-orthogonal leads opened the door for mobile assessment of the three-dimensional cardiac vector by self-measurement. We hypothesize that the information provided is sufficient for accurate reconstruction of the 12-lead ECG. We propose a reconstruction algorithm based on the segment-by-segment 4-matrix (4M) transformation applied to the P wave, QRS complex, ST segment, and T wave. The accuracy of the 4M method was tested using data obtained from 64 healthy volunteers. The 4M method reconstructed the standard 12-lead ECG with a 0.96 mean cross-correlation for all leads and provided meaningful clinical results. A back-to-back comparative study demonstrated the superiority of the proposed method over the traditional EASI method. In addition, the results provide evidence of the capability of the 3-lead 4M technology to accurately reconstruct the full cardiac vector from a single measurement, which distinguishes it from competition. Although further clinical investigation is necessary, wireless operation and high accuracy make the proposed method potentially suitable for remote monitoring and self-assessment.