Optimal electrode placements for the identification of old MI and LVH

Past studies have demonstrated the improved diagnostic utility of the electrocardiogram by utilizing alternative recording sites to that used in the standard 12-lead. The present study proposes new lead sets based on the developments of innovative computational models. Utilizing 744 117-lead body surface potential maps the diagnostic value of different recording site combinations was evaluated. Three lead sets were derived; sites discriminating between subjects with evidence of old myocardial infarction and healthy subjects; sites discriminating between subjects with left ventricular hypertrophy and healthy subjects; and sites discriminating between the two disease types. A wrapper approach incorporating a nearest neigbour classifier was adopted to facilitate the lead selection process. Following 10-fold cross validation the recording sites chosen for LVH vs Normal, MI vs Normal and MI vs LVH yielded sensitivities of 89%, 89% and 75%, and specificities of 91%, 94% and 65%, respectively.