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Updated: Jun 13, 2026

Patient Directed Recording of a Bipolar Three-Lead Electrocardiogram using a Smartwatch with ECG Function
Published on: December 11, 2019
New precordial bipolar electrocardiographic leads for detecting left ventricular hypertrophy
Merja Puurtinen1, Juho Väisänen, Jari Viik
1Department of Biomedical Engineering, Tampere University of Technology, Tampere, Finland. merja.puurtinen@uta.fi
Background:
Novel small and wearable electrocardiogram (ECG) devices offer new means of recording cardiac activity in different applications. Our objective was to evaluate the performance of closely separated (6 cm) bipolar leads in differentiating subjects with left ventricular hypertrophy (LVH) from healthy subjects.
Methods:
The material contained body surface ECG of 236 healthy and 116 LVH subjects. A total of 36 vertical, 30 horizontal, and 66 diagonal bipolar leads located on the anterior thorax were analyzed. The QRS amplitudes were calculated, and the leads' overall diagnostic performance was assessed by receiver operating characteristic (ROC) analysis.
Results:
The best overall diagnostic performances were obtained from 2 areas: one near the precordial electrodes of standard leads V(1) to V(3) and the other on lower anterior thorax. Vertical and diagonal bipolar leads located at lower anterior thorax provided the highest ROC areas (≥0.79). These bipolar leads also provided similar sensitivities than the traditional Sokolow-Lyon method.
Conclusion:
The new short distance vertical and diagonal bipolar leads are efficient in discriminating subjects with LVH from healthy subjects based on QRS amplitude.
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