{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:36:33Z","timestamp":1791826593301,"version":"4.3.4"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This paper aims to review the literature on 12-lead ECG reconstruction, highlight various algorithmic approaches and evaluate their predictive strengths. In addition, it investigates the implications of performing reconstruction in particular ways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This narrative review analysed 39 works on the reconstruction of 12-lead ECGs, focusing on the algorithms used for reconstruction and the results gotten from using these algorithms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The works analysed featured the use of as little as one lead and as much as four leads for reconstruction of the other leads. Linear and nonlinear (including artificial intelligence) algorithms showed promising performances. Their outputs had correlations of greater than 0.90 depending on how the reconstruction models were built.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Three leads are optimal as input predictors for minimal reconstruction errors, but there is no universal algorithm that applies to every reconstruction task. Both linear and nonlinear algorithms can achieve high correlations, and minimal root means square errors. Hence, planned steps are needed when deciding how to manipulate the data and build the models to achieve high accuracies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2025.1532284","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T01:23:32Z","timestamp":1745544212000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Reconstruction of 12-lead ECG: a review of algorithms"],"prefix":"10.3389","volume":"16","author":[{"given":"Ekenedirichukwu N.","family":"Obianom","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Andr\u00e9","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"14383","DOI":"10.3402\/jchimp.v2i1.14383","article-title":"A brief review: history to understand fundamentals of electrocardiography","volume":"2","author":"AlGhatrif","year":"2012","journal-title":"J. community Hosp. Intern. Med. Perspect."},{"key":"B2","first-page":"161","article-title":"A neural network approach for patient-specific 12-lead ECG synthesis in patient monitoring environments","author":"Atoui","year":"2004"},{"key":"B3","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1109\/TITB.2010.2047754","article-title":"A novel neural-network model for deriving standard 12-lead ECGs from serial three-lead ECGs: application to self-care","volume":"14","author":"Atoui","year":"2010","journal-title":"IEEE Trans. Inf. Technol. Biomed."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2525","DOI":"10.3390\/diagnostics13152525","article-title":"Telemedicine in the era of a pandemic: usefulness of a novel three-lead ECG","volume":"13","author":"Babic","year":"2023","journal-title":"Diagn. (Basel)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.22489\/CinC.2017.093-231","article-title":"Application of an inverse-forward approach to derive the 12-lead ECG from body surface potential maps","volume":"44","author":"Bear","year":"2017","journal-title":"Comput. Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1186\/s12911-022-02063-6","article-title":"Electrocardiogram lead conversion from single-lead blindly-segmented signals","volume":"22","author":"Beco","year":"2022","journal-title":"Bmc Med. Inf. Decis. Mak."},{"key":"B7","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1515\/BMTE.1995.40.S1.317","article-title":"Nutzung der EKG-Signaldatenbank CARDIODAT der PTB \u00fcber das Internet","volume":"40","author":"Bousseljot","year":"1995","journal-title":"Biomed. Tech.\/Biomed. Eng."},{"key":"B8","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1114\/1.49","article-title":"A field-compatible method for interpolating biopotentials","volume":"26","author":"Burnes","year":"1998","journal-title":"Ann. Biomed. Eng."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.3390\/biomedicines11061526","article-title":"Importance of electrode selection and number in reconstructing standard twelve lead electrocardiograms","volume":"11","author":"Butchy","year":"2023","journal-title":"Biomedicines"},{"key":"B10","first-page":"289","article-title":"Standard 12-lead ECG synthesis using a GA optimized BP neural network","author":"Chen","year":"2015"},{"key":"B11","first-page":"320","article-title":"Reconstruction of 12-lead ECG with an optimized LSTM neural network","author":"Dhahri","year":"2022"},{"key":"B12","doi-asserted-by":"publisher","first-page":"S182","DOI":"10.1016\/0022-0736(88)90090-8","article-title":"Deriving the 12-lead electrocardiogram from four (EASI) electrodes","volume":"21","author":"Dower","year":"1988","journal-title":"J. Electrocardiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1002\/clc.1980.3.2.87","article-title":"On deriving the electrocardiogram from vectorcardiographic leads","volume":"3","author":"Dower","year":"1980","journal-title":"Clin. Cardiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1177\/003591571200500267","article-title":"Observations of the movements of the heart by means of electrocardiograms","volume":"5","author":"Einthoven","year":"1912","journal-title":"J. R. Soc. Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1016\/j.jelectrocard.2008.07.019","article-title":"Technical challenges and future directions in lead reconstruction for reduced-lead systems","volume":"41","author":"Feild","year":"2008","journal-title":"J. Electrocardiol."},{"key":"B16","first-page":"281","article-title":"Effects of electrode misplacement on the reconstruction of the 12-lead ECG","author":"Finlay","year":"2009"},{"key":"B17","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1161\/01.RES.2.3.258","article-title":"General theory of heat-vector projection","volume":"2","author":"Frank","year":"1954","journal-title":"Circulation Res."},{"key":"B18","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1161\/01.CIR.13.5.737","article-title":"An accurate, clinically practical system for spatial vectorcardiography","volume":"13","author":"Frank","year":"1956","journal-title":"Circ. (New York, N.Y.)"},{"key":"B19","first-page":"1","article-title":"Single-lead to multi-lead electrocardiogram reconstruction using a modified attention U-net framework","author":"Garg","year":"2023"},{"key":"B20","doi-asserted-by":"publisher","first-page":"E215","DOI":"10.1161\/01.CIR.101.23.e215","article-title":"PhysioBank, PhysioToolkit, and PhysioNet: components of a new research resource for complex physiologic signals","volume":"101","author":"Goldberger","year":"2000","journal-title":"Circulation"},{"key":"B21","doi-asserted-by":"publisher","first-page":"5542","DOI":"10.3390\/s21165542","article-title":"Lead reconstruction using artificial neural networks for ambulatory ECG acquisition","volume":"21","author":"Grande-Fidalgo","year":"2021","journal-title":"Sensors (Basel)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1016\/j.jelectrocard.2008.07.018","article-title":"Where do derived precordial leads fail?","volume":"41","author":"Gregg","year":"2008","journal-title":"J. Electrocardiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1016\/j.jelectrocard.2012.08.012","article-title":"Estimation performance of a reduced lead system during continuous 12-lead ECG ST-segment monitoring","volume":"45","author":"Guldenring","year":"2012","journal-title":"J. Electrocardiol."},{"key":"B24","first-page":"01","article-title":"A novel single lead to 12-lead ECG reconstruction methodology using convolutional neural networks and LSTM","author":"Gundlapalle","year":"2022"},{"key":"B25","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.jelectrocard.2011.09.003","article-title":"Wireless remote monitoring of reconstructed 12-lead ECGs after ablation for atrial fibrillation using a hand-held device","volume":"45","author":"Gussak","year":"2012","journal-title":"J. Electrocardiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1109\/titb.2004.837869","article-title":"A novel mobile transtelephonic system with synthesized 12-lead ECG","volume":"8","author":"Hadzievski","year":"2004","journal-title":"IEEE Trans. Inf. Technol. Biomed."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1126\/science.134.3486.1214","article-title":"New method for heart studies","volume":"134","author":"Holter","year":"1961","journal-title":"Science"},{"key":"B28","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.jelectrocard.2008.02.010","article-title":"On designing and testing transformations for derivation of standard 12-lead\/18-lead electrocardiograms and vectorcardiograms from reduced sets of predictor leads","volume":"41","author":"Hor\u00e1cek","year":"2008","journal-title":"J. Electrocardiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"5481","DOI":"10.1109\/EMBC.2019.8857251","article-title":"Signal quality in reconstructed 12-lead ambulatory ECGs recorded using 3-lead device","volume":"2019","author":"Ivanovic","year":"2019","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"B30","first-page":"296","article-title":"LSTM based synthesis of 12-lead ECG signal from a reduced lead set","author":"Kapfo","year":"2022"},{"key":"B31","doi-asserted-by":"publisher","first-page":"963","DOI":"10.3390\/s20040963","article-title":"Optimal lead position in patch-type monitoring sensors for reconstructing 12-lead ECG signals with universal transformation coefficient","volume":"20","author":"Lee","year":"2020","journal-title":"Sensors (Basel)"},{"key":"B32","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1109\/jbhi.2015.2415519","article-title":"Reconstruction of precordial lead electrocardiogram from limb leads using the state-space model","volume":"20","author":"Lee","year":"2016","journal-title":"Ieee J. Biomed. Health Inf."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1136\/bmj.1.2686.1421","article-title":"Electro-cardiography and its importance in the clinical examination of heart affections","volume":"1","author":"Lewis","year":"1912","journal-title":"BMJ"},{"key":"B34","first-page":"233","article-title":"Accurate and reliable 3-lead to 12-lead ECG reconstruction methodology for remote health monitoring applications","author":"Maheshwari","year":"2013"},{"key":"B35","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.jelectrocard.2015.12.008","article-title":"Frank vectorcardiographic system from standard 12 lead ECG: an effort to enhance cardiovascular diagnosis","volume":"49","author":"Maheshwari","year":"2016","journal-title":"J. Electrocardiol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/0002-8703(66)90182-7","article-title":"A new system of multiple-lead exercise electrocardiography","volume":"71","author":"Mason","year":"1966","journal-title":"Am. Heart J."},{"key":"B37","first-page":"1","article-title":"Feasibility of ECG reconstruction from minimal lead sets using convolutional neural networks","author":"Matyschik","year":"2020"},{"key":"B38","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1109\/cic.2000.898485","article-title":"PhysioNet: a research resource for studies of complex physiologic and biomedical signals","volume":"27","author":"Moody","year":"2000","journal-title":"Comput. Cardiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1109\/51.932724","article-title":"The impact of the MIT-BIH arrhythmia database","volume":"20","author":"Moody","year":"2001","journal-title":"IEEE Eng. Med. Biol. Mag."},{"key":"B40","doi-asserted-by":"publisher","first-page":"15","DOI":"10.11591\/ijeei.v7i1.937","article-title":"Improving accuracy of derived 12-lead electrocardiography by waveform segmentation","volume":"7","author":"Mulyadi","year":"2019","journal-title":"Indones. J. Electr. Eng. Inf."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1016\/j.amjcard.2004.08.031","article-title":"Assessment of derived 12-lead electrocardiograms using general and patient-specific reconstruction strategies at rest and during transient myocardial ischemia","volume":"94","author":"Nelwan","year":"","journal-title":"Am. J. Cardiol."},{"key":"B43","first-page":"705","article-title":"Evaluation of limited and alternative lead sets for the reconstruction of the 12-lead electrocardiogram and Body surface potential maps","author":"Nelwan","year":"2007"},{"key":"B44","first-page":"213","article-title":"Improved 12-lead ECG reconstruction from lead sub sets by dynamic selection of frontal leads","author":"Nelwan","year":""},{"key":"B45","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.jelectrocard.2008.01.011","article-title":"Simultaneous comparison of 3 derived 12-lead electrocardiograms with standard electrocardiogram at rest and during percutaneous coronary occlusion","volume":"41","author":"Nelwan","year":"","journal-title":"J. Electrocardiol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1054\/jelc.2000.20296","article-title":"Minimal lead sets for reconstruction of 12-lead electrocardiograms","volume":"33","author":"Nelwan","year":"2000","journal-title":"J. Electrocardiol."},{"key":"B47","first-page":"5","article-title":"Efficacy of a reduced lead set for pre-hospital triage of thrombolytic strategies","author":"Nelwan","year":""},{"key":"B48","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.jelectrocard.2003.10.004","article-title":"Reconstruction of the 12-lead electrocardiogram from reduced lead sets","volume":"37","author":"Nelwan","year":"","journal-title":"J. Electrocardiol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1054\/jelc.2001.28895","article-title":"Correction of ECG variations caused by body position changes and electrode placement during ST-T monitoring","volume":"34","author":"Nelwan","year":"2001","journal-title":"J. Electrocardiol."},{"key":"B50","first-page":"298","article-title":"Simultaneous denoising and reconstruction of 12-lead electrocardiogram","author":"Obianom","year":"2024"},{"key":"B51","doi-asserted-by":"publisher","first-page":"4414","DOI":"10.1109\/IEMBS.2011.6091095","article-title":"Reconstructing ECG precordial leads from a reduced lead set using independent component analysis","volume":"2011","author":"Ostertag","year":"2011","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"B52","first-page":"316","article-title":"Synthesis of 12-lead ECG from a reduced lead set using singular value decomposition","author":"Padhy","year":"2016"},{"key":"B53","article-title":"Personalised system-on-chip and mobile-app for standard 12-lead reconstruction from the reduced 3-lead system targeting remote health care","author":"Panda","year":"2014"},{"key":"B54","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/S0022-0736(07)80112-9","article-title":"Synthesis of the 12-lead electrocardiogram from a 3-lead subset using patient-specific transformation vectors. An algorithmic approach to computerized signal synthesis","volume":"22","author":"Scherer","year":"1989","journal-title":"J. Electrocardiol."},{"key":"B55","first-page":"91","article-title":"Evaluation of 12-lead ECG synthesis using analysis measurements in 240 patients","author":"Scherer","year":"1992"},{"key":"B56","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1111\/j.1553-2712.1998.tb02825.x","article-title":"Statistical methodology: VI. Mathematical modeling of the electrocardiogram using factor analysis","volume":"5","author":"Schreck","year":"1998","journal-title":"Acad. Emerg. Med."},{"key":"B57","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1109\/metroind4.0iot57462.2023.10180025","article-title":"Standard 12-lead ECG synthesis from homecare wearable measures","author":"Sindreu","year":"2023","journal-title":"2023 IEEE Int. Workshop Metrol. Ind. 4. 0. and IoT"},{"key":"B58","doi-asserted-by":"publisher","first-page":"47","DOI":"10.6515\/ACS.202101_37(1).20200712A","article-title":"The reconstruction of a 12-lead electrocardiogram from a reduced lead set using a focus time-delay neural network","volume":"37","author":"Smith","year":"2021","journal-title":"Acta Cardiol. Sin."},{"key":"B59","doi-asserted-by":"publisher","first-page":"3278","DOI":"10.3390\/s20113278","article-title":"Reconstruction of 12-lead electrocardiogram from a three-lead patch-type device using a LSTM network","volume":"20","author":"Sohn","year":"2020","journal-title":"Sensors (Basel)"},{"key":"B60","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1109\/JBHI.2013.2294561","article-title":"Patient-specific 12-lead ECG reconstruction from sparse electrodes using independent component analysis","volume":"18","author":"Tsouri","year":"2014","journal-title":"IEEE J. Biomed. and Health Inf."},{"key":"B61","doi-asserted-by":"crossref","DOI":"10.22489\/CinC.2019.231","article-title":"A novel 2-lead to 12 lead ECG reconstruction methodology for remote health monitoring applications","author":"Vemishetty","year":"2019"},{"key":"B62","first-page":"1113","article-title":"Wireless remote monitoring of atrial fibrillation using reconstructed 12-lead ECGs","author":"Vukajlovic","year":"2010"},{"key":"B63","doi-asserted-by":"publisher","first-page":"4741","DOI":"10.1109\/IEMBS.2011.6091174","article-title":"Wireless monitoring of reconstructed 12-lead ECG in atrial fibrillation patients enables differential diagnosis of recurrent arrhythmias","volume":"2011","author":"Vukajlovic","year":"2011","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"B64","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.1109\/IEMBS.2010.5626215","article-title":"Wireless remote monitoring of myocardial ischemia using reconstructed 12-lead ECGs","volume":"2010","author":"Vukcevic","year":"2010","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"B65","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1038\/s41597-020-0495-6","article-title":"PTB-XL, a large publicly available electrocardiography dataset","volume":"7","author":"Wagner","year":"2020","journal-title":"Sci. Data"},{"key":"B66","first-page":"199","article-title":"Optimal placement of dual chest leads for deriving 12-lead\/18-lead electrocardiograms and vectorcardiograms","author":"Wang","year":"2005"},{"key":"B67","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1631\/FITEE.1700413","article-title":"A novel method based on convolutional neural networks for deriving standard 12-lead ECG from serial 3-lead ECG","volume":"20","author":"Wang","year":"2019","journal-title":"Front. Inf. Technol. Electron. Eng."},{"key":"B68","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1161\/01.CIR.10.4.564","article-title":"RECOMMENDATIONS for standardization of electrocardiographic and vectorcardiographic leads","volume":"10","author":"Wilson","year":"1954","journal-title":"Circ. (New York, N.Y.)"},{"key":"B69","first-page":"1","article-title":"Method of ECG lead recovery from 3-lead to 12-lead","author":"Xu","year":"2021"},{"key":"B70","first-page":"275","article-title":"Reconstruction of 12-lead electrocardiogram based on GVM","author":"Xu","year":"2018"},{"key":"B71","first-page":"709","article-title":"Adapting ECG morphology changes from reduced-lead set by specifically trained algorithms for acute ischemia detection","author":"Xue","year":"2007"},{"key":"B72","first-page":"12","article-title":"Electrocardiogram reconstruction using support vector regression","author":"Yodjaiphet","year":"2012"},{"key":"B73","doi-asserted-by":"publisher","first-page":"104690","DOI":"10.1016\/j.bspc.2023.104690","article-title":"Restoration of missing or low-quality 12-lead ECG signals using ensemble deep-learning model with optimal combination","volume":"83","author":"Yoo","year":"2023","journal-title":"Biomed. Signal Process. Control"},{"key":"B74","first-page":"1","article-title":"Chest-lead generation with single-lead","author":"Yoon","year":"2022"},{"key":"B75","first-page":"103","article-title":"All-ECG: a least-number of leads ECG monitor for standard 12-lead ECG tracking during motion","author":"Zhang","year":"2019"},{"key":"B76","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1038\/s41597-020-0386-x","article-title":"A 12-lead electrocardiogram database for arrhythmia research covering more than 10,000 patients","volume":"7","author":"Zheng","year":"2020","journal-title":"Sci. data"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1532284\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T09:39:16Z","timestamp":1747129156000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1532284\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,25]]},"references-count":75,"alternative-id":["10.3389\/fphys.2025.1532284"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2025.1532284","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,25]]},"article-number":"1532284"}}