Measurement of 12-Lead ECG Using Multi-Orientation Electrodes on the Left Upper Arm in Healthy Subjects.

PURPOSE: Wearable technologies for cardiac monitoring have facilitated long-term electrocardiogram (ECG) data acquisition. This study presents an alternative approach for obtaining 12-lead associated ECG signals using electrodes strategically placed around the left upper arm (LUA-ECG). We validated whether this LUA-ECG configuration can reliably capture the morphological and quantitative characteristics of standard 12-lead ECG in healthy subjects. METHOD: The procedure was conducted in two sequential phases. Initially, standard 12-lead ECG and LUA-ECG were simultaneously recorded from thirty healthy adults. The LUA-ECG system captured 28 differential leads through a multi-electrode configuration strategically positioned around the arm. Among these 28 signals, eight key differential leads corresponding to the standard 12-lead configuration were selected to obtain the 12-lead ECG. In the subsequent phase, the fidelity of the obtained 12-lead ECG was evaluated by comparing it against the standard 12-lead ECG. The comparative analysis focused on key clinical features, including RR interval, PR interval, QRS duration, QT interval, and corrected QT interval (QTc). RESULTS: The mean correlation of waveform from eight selected LUA-ECG signals compared with standard 12-lead ECG ranged 0.72 to 0.90. The mean absolute errors (MAE) for RR interval, PR interval, QRS duration, QT interval, and QTc of extracted 12-lead ECG derived from LUA-ECG ranged from 4.57 to 7.77 ms at a 500 Hz sampling rate. CONCLUSION: The developed LUA-ECG system provides a reliable approach for long-term ECG monitoring. The extracted 12-lead ECG derived from LUA-ECG signal components effectively provides morphological and temporal features associated with conventional 12-lead ECG, demonstrating its potential for extended-duration monitoring applications.