Use of dual chest leads for deriving complete 12-lead/18-lead electrocardiograms and vectorcardiograms in infants

We developed infant-specific transformations of ECG leads and compared their performance with that achieved by transformations derived for adults. In particular, we studied the ability of 15 reduced lead sets consisting of Mason-Likar (M-L) limb leads and 2 precordial leads to predict the complete set of M-L 12 leads, plus right-sided, posterior, and orthogonal leads. The study population consisted of 82 infants aged 6 to 365 days, for whom 120- lead ECG data were available. Lead transformations were derived by regression analysis and the ability of reduced lead sets to predict desired leads was assessed by 3 measures of fit. The results show that, with infant- specific transformations, 12 pairs of precordial leads have almost the same predictive ability. In comparison of adult vs. infant transformations the former fared well for the right-sided, precordial, and orthogonal leads, but failed for the posterior leads; the latter performed well for all the leads and thus they are preferable.