Investigation of the ECG Leads Sensitivity to Myocardial Ischemia by Means of Biophysical Model

A research of electrocardiogram leads sensitivity to changes in the shape of the transmembrane action potential curve, reflecting manifestation and development of myocardial ischemia was conducted. The research investigated different areas affected by ischemia and different scenarios of ischemia occurrence. The simulation indicated that changes occurred in ST-T interval were significantly higher than in both whole curve and QRS complex. However, sensitivity ratio of leads remained almost the same with small fluctuations. In all ischemia simulation scenarios sensitivity of precordial leads exceeded limb leads and augmented limb leads sensitivity (more than 63%). The most sensitive to simulated myocardial ischemia were four precordial leads V2 (12 %), V3 and V4 (about 14% in average each) and V5 (10 %), on ST-T interval and on the whole curve.