Session S63.6

Optimization of Electrode Positions of a Wearable ECG Monitoring System for Efficient and Effective Detection of Acute Myocardial Infarction

Y Jiang*, C Qian, R Hanna, D Farina, O Dössel

Karlsruhe Institute of Technology
Karlsruhe, Germany

Myocardial infarction occurs when the blood and oxygen supply to the myocardium is dramatically decreased or interrupted due to, e.g., blockage of a coronary artery. It is the leading cause of morbidity and mortality all over the world. Therefore, it is of very high importance to detect the infarction effectively in its early phase with an efficient method. Electrocardiogram provides a non-invasive and non-expensive way for diagnosis of myocardial infarction through seeking for the ischemic syndromes in ECG, e.g., the elevation or depression of ST-segment. However, the standard 12 lead ECG does not examine the heart from all aspects and the comprehensive body surface potential mapping system is nearly impossible to be wearable. In the present project a wearable ECG monitoring system for detection of acute myocardial infarction is optimized with respect to electrode positions. This system is expected to involve a minimal number of electrodes with positions optimized for the detection of myocardial ischemia and infarctions.
The objective of the present study is the determination of an optimal electrode configuration of the proposed wearable ECG monitoring system by means of computer simulation. It can be observed, that using only 2 electrodes many infarctions do not show any change in ST-segment and thus cannot be detected (silent infarction). Optimum in this work means: no infarction will be missed. For this purpose, an individual computer model is built from a patient's MRI data. The electrical activities in the heart are simulated using a cellular automaton. 153 myocardial infarctions of different sizes and at various sites in the entire left ventricular wall and septum, i.e., 9 infarctions simulated in each AHA segment, are simulated and the corresponding body surface potentials are computed using the finite element method. The ST-integral of the body surface electrical potentials of different myocardial infarctions are analyzed using singular value decomposition theory and compared with the simulated healthy body surface potentials (no infarction). According to the analysis, an optimal electrode configuration is suggested, which consists of 4 electrodes, i.e., one electrode on the left chest directly above the heart, one electrode below the fossa jugularis, one electrode on the right chest and one electrode on the left back. For the validation, 50 additional simulations with infarctions in the left ventricle, whose sites and sizes are randomly generated, are performed. The 50 random infarctions are examined using the suggested electrode configuration and a high accuracy of 98% is achieved.

(Abstract Control Number: 23)