Derive right precordial leads at higher intercostal spaces from 12-lead system for diagnosis of Brugada syndrome

Recording the right procordial leads at higher intercostal spaces (ICS) can raise the sensitivity of the diagnosis on Brugada syndrome using ECG. However, the directive measurement of the right precordial leads at the higher ICSs is tedious and impractical. In this paper, we proposed a derivation method based on the information redundancy in the 12-lead system to study the possibility of deriving the right precordial leads at the higher ICSs from the commonly used Mason-Likar 12-lead ECGs. Through the evaluation based on the simulated Brugada-type ECGs and recorded ECGs from BS subjects, we found that the BS characteristic J wave and coved type ST elevation in the right precordial leads at the higher ICSs could be satisfyingly derived from the 12-lead ECGs. It is concluded that the derived precordial leads at the higher ICSs may serve as an assistant diagnosis tool to unmask Brugada syndrome.