When deriving the spatial QRS-T angle from the 12-lead electrocardiogram, which transform is more Frank: regression or inverse Dower?

Daniel L. Cortez, Todd T. Schlegel

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Introduction: Our primary objective was to ascertain which commonly used 12-to-Frank-lead transformation yields spatial QRS-T angle values closest to those obtained from simultaneously collected true Frank-lead recordings. Materials and Methods: Simultaneous 12-lead and Frank XYZ-lead recordings were analyzed for 100 postmyocardial infarction patients and 50 controls. Relative agreement, with true Frank-lead results, of 12-to-Frank-lead-transformed results for the spatial QRS-T angle using Kors' regression versus inverse Dower was assessed via analysis of variance, Lin's concordance, and Bland-Altman plots. Results: Spatial QRS-T angles from the true Frank leads were not significantly different than those derived from the Kors' regression-related transformation but were significantly smaller than those derived from the inverse Dower-related transformation (P < .001). Independent of method, spatial mean QRS-T angles were also always significantly larger than spatial "maximum" ("peaks") QRS-T angles. Discussion: Spatial QRS-T angles are best approximated by regression-related transforms. Spatial mean and spatial "peaks" QRS-T angles should not be used interchangeably.

Original languageEnglish (US)
Pages (from-to)302-309
Number of pages8
JournalJournal of Electrocardiology
Volume43
Issue number4
DOIs
StatePublished - Jul 2010
Externally publishedYes

Bibliographical note

Funding Information:
The authors especially thank Oeff et al and physionet.org for providing access to the PTB Diagnostic ECG Database. They also thank Drs W.B. Kulecz, J.L. DePalma, and E.C. Greco for programming and technical assistance and Dr R. Ploutz-Snyder for statistical advice. Additional support was provided by the National Space Biomedical Research Institute and NASA/Wyle Laboratories medical student internship programs (DLC) and NASA Technology Investment Funds (TTS).

Keywords

  • 3-Dimensional ECG
  • Lead reconstruction
  • Spatial ventricular gradient
  • Vectorcardiography

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