Michael Green, Mattias Ohlsson, Jakob Forberg, Jonas Björk, Lars Edenbrandt and Ulf Ekelund
Most important leads in the standard ECG for the emergency detection of acute coronary syndrome
To appear in Journal of Electrocardiology (2007)

Background and Purpose:
The purpose of this study was to determine which leads in the standard 12-lead ECG are the most important for detecting acute coronary syndrome (ACS) among chest pain patients in the emergency department (ED).

Neural networks classifiers were used to determine the predictive capability of individual leads and combinations of leads from 862 ECGs from chest pain patients in the ED at Lund University Hospital.

The best individual lead was aVL with an area under the receiver operating characteristics (ROC) curve of 75.5%. The best 3-lead combination was III, aVL and V2 with a ROC area of 82.0%, compared to the 12-lead ECG performance of 80.5%.

Our results indicate leads III, aVL and V2 are sufficient for computerized prediction of ACS. The present results are likely important for situations where the 12-lead ECG is impractical, and for the creation of clinical decision support systems for ECG prediction of ACS.

LU TP 06-24