Estimation accuracy of a reduced lead system during simulated ischemia

In this study we investigate the influence of ischemic events on the estimation accuracy of a reduced lead system based on leads I, II, V2 and V5. The estimation accuracy of this lead system has been assessed for generalized and patient specific lead derivation. Assessments have been performed on a piecewise homogenous torso model that has been used to simulated ischemic events of different size and location. The patient specific lead derivation approach achieved root mean squared error (RMSE) values of 4.7μV, 24.4μV, 4.4μV and 2.6μV for derived leads V1, V3, V4 and V6 when no ischemia was simulated. It was found that RMSE values for patient specific derived leads increased when ischemia was simulated. Median RMSE values calculated for each lead and across all simulated ischemic events were found to be 40.0μV, 126.7μV, 38.2μV and 35.1μV for derived leads V1, V3, V4 and V6. These values are comparable to the median RMSE values 52.7μV, 141.7μV, 46.9μV and 20.3μV for derived leads V1, V3, V4 and V6 that were found when generalized lead derivation was performed for all ischemic events.