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European Heart Journal 1990 11(12):1083-1092;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Reconstruction of the Frank vectorcardiogram from standard electrocardiographic leads: diagnostic comparison of different methods

J. A. KORS*,, G. VAN HERPEN+, A. C. SITTIG*,** and J. H. VAN BEMMEL*

*Department of Medical Informatics, Faculty of Medicine and Health Sciences, Erasmus University Rotterdam
+Division of Cardiology, Academic Hospital Leiden, The Netherlands

Received ; revised 12 March 1990; .

Correspondence address: J. A. Kors, Department of Medical Informatics, Faculty of Medicine and Health Sciences, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.

Abstract

Three methods for reconstructing the Frank VCG from the standard 12-lead ECG were studied. The first was based on multivariate regression, the second on a model of the cardio-electrical activity, and the third method used a quasi-orthogonal set of ECG leads.

The methods were evaluated on a test set of 90 cases by a numerical distance measure and by the agreement in diagnostic classification of the original and reconstructed VCGs. The original and reconstructed VCGs were presented separately and in random order to three referees. Eighteen of the original VCGs were presented three times to estimate the intra-observer agreement. Kappa statistics were used to quantify the agreement between diagnostic classifications. Separately, one referee was simultaneously presented the original VCG and its three reconstructions for all cases. Each reconstruction VCG was classified as either diagnostically ‘same’ as the original, ‘borderline’or ‘different’.

The performance of the regression method and the model-based method was comparable. Both methods were preferable to the quasi-orthogonal method. The kappa values for the preferred methods indicated a good to excellent diagnostic agreement between the original and reconstructed VCGs. Only one out of ninety VCGs that were reconstructed with the regression method was classified as ‘different’ compared with the original VCGs; three VCGs were classified as ‘different’ with the model-based method. It was also found that estimation of similarity by a distance measure could not replace diagnostic evaluation by skilled observers.

Key Words: VCG reconstruction • evaluation of diagnoses • kappa statistic


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