Aimed Electrocardiography with Simple Bipolar Leads

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Abstract
All currently employed ECG and VCG leads vectorially record added contributions from all cardiac regions. Aimed leads, if feasible, would yield information cancelled during addition. Three artificial dipoles (µ1, µ2, µ3) are placed within a torso model in the approximate right ventricular free wall, posterobasal wall of left ventricle, and inferior cardiac surface, respectively. Dipoles are excited in turn and torso surface potential fields are mapped for each dipole. A bipolar lead connecting any pair of points on the same equipotential of the field produced by µ1 does not show a deflection when µ1 is excited, but responds to µ2 and µ3. If this lead is now so placed that its two electrodes, while remaining on the µ1 equipotential, are on the same equipotential of the µ2 field as well, then it will respond to µ3alone; it is aimed at the latter. Superimposing the three field maps and searching for those equipotential lines of one map which cross the same equipotential line of another map twice, provides a large number of suitable leads, each aimed at one of the three dipoles. Five leads are described and tested in detail.