July 11, 2019Open Access

Comparison of Different Electrocardiography with Vectorcardiography Transformations

RJRené JarošVSB - Technical University of Ostrava RMRadek MartínekVSB - Technical University of Ostrava LDLukáš DanysVSB - Technical University of Ostrava

Structured PICO

Do specific mathematical transformations (such as Kors regression) improve the accuracy of deriving vectorcardiographic leads from standard 12-lead ECGs compared to other transformation methods?

Population

Electrocardiographic data from the Physikalisch-Technische Bundesanstalt (PTB) database

Intervention

Mathematical transformations for deriving vectorcardiography (VCG) from 12-lead ECG (Kors quasi-orthogonal transformation, inverse Dower transformation, Kors regression transformation, and linear regression-based transformations PLSV and QLSV)

Comparator

Directly measured Frank's orthogonal leads (conventional VCG)

Outcome

Accuracy evaluated using mean squared error (MSE) and correlation coefficient (R) between derived and directly measured Frank's leadssurrogate

Kors regression transformation provides the most accurate mathematical derivation of X and Y vectorcardiographic leads from standard 12-lead ECGs when compared to directly measured Frank's leads.

Abstract

This paper deals with transformations from electrocardiographic (ECG) to vectorcardiographic (VCG) leads. VCG provides better sensitivity, for example for the detection of myocardial infarction, ischemia, and hypertrophy. However, in clinical practice, measurement of VCG is not usually used because it requires additional electrodes placed on the patient's body. Instead, mathematical transformations are used for deriving VCG from 12-leads ECG. In this work, Kors quasi-orthogonal transformation, inverse Dower transformation, Kors regression transformation, and linear regression-based transformations for deriving P wave (PLSV) and QRS complex (QLSV) are implemented and compared. These transformation methods were not yet compared before, so we have selected them for this paper. Transformation methods were compared for the data from the Physikalisch-Technische Bundesanstalt (PTB) database and their accuracy was evaluated using a mean squared error (MSE) and a correlation coefficient (R) between the derived and directly measured Frank's leads. Based on the statistical analysis, Kors regression transformation was significantly more accurate for the derivation of the X and Y leads than the others. For the Z lead, there were no statistically significant differences in the medians between Kors regression transformation and the PLSV and QLSV methods. This paper thoroughly compared multiple VCG transformation methods to conventional VCG Frank's orthogonal lead system, used in clinical practice.

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