Device for performing a multi-channel ECG and a method for performing a multi-channel ECG

Abstract

The invention relates to a computer-implemented method for providing leads for a 12-lead ECG, the method comprising: - receiving data representing a measured voltage or voltage difference from a number of electrodes that at least include frontal electrodes comprising a first right frontal electrode (RA), a first left frontal electrode (LA), a second left frontal electrode (LL) and a second right frontal electrode (RL); - determining, from the received data, 12 leads for a 12-lead ECG, wherein the step of determining comprises determining at least one precordial lead based on the data representing a measured voltage or voltage difference from at least one of the frontal electrodes. The invention further relates to a computer-implemented method for providing a 12-lead ECG and a 12-lead ECG-device configured for measuring a 12-lead ECG. The invention also relates to a computer program and a computer-readable storage medium.

Description

[0001]DEVICE FOR PERFORMING A MULTI-CHANNEL ECG AND A METHOD FOR PERFORMING A MULTI-CHANNEL ECG The invention relates to a device for performing a multi-channel ECG and a method for performing a multi-channel ECG. A heart generates an electric pulse which causes the heart to pump and circulates blood through the blood vessels. Due to the electrical pulses an electrical field is generated which can be detected by electrodes. These electrodes can be positioned on the body or inside the body. Conventional devices for recording a multi-channel-ECG, for example those used in hospitals, provide a 12-lead ECG, which contains three bipolar leads, three augmented bipolar leads and six precordial leads. In order to perform a 12-lead ECG, at least ten electrodes are required, which are positioned on various places on the body. This contains four frontal or limb electrodes, which are placed at or at least near each of the limbs. The four frontal electrodes are used to measure and / or calculate the bipolar and augmented unipolar leads. In order to measure the precordial leads six electrodes are placed at specific places at the chest. The electrodes generally form a slightly curved line on the chest. This approach will then result in a 12-channel-ECG which shows the electrical activities of the heart in a frontal, sagittal and / or horizontal plane. A disadvantage of this method is that it requires complex and large equipment as well as an (experienced) operator to perform the various actions required to obtain (and interpret) the ECG. As a result, registering a diagnostic 12-lead ECG is complex and time-consuming and not easily performed by non-professionals. The object of the invention is to provide a method for registering a diagnostic 12-lead ECG that is less complex and time-consuming. This object is achieved with a computer-implemented method for providing 12 leads for a 12-lead ECG, the method comprising: ̵ receiving data representing a measured voltage or voltage difference from a number of electrodes that at least include frontal electrodes comprising a first right frontal electrode (RA), a first left frontal electrode (LA), a second left frontal electrode (LL) and a second right frontal electrode (RL); and ̵ determining, from the received data, 12 leads for a 12-lead ECG, wherein the step of determining comprises determining at least one precordial lead based on the data representing a measured voltage or voltage difference from at least one of the frontal electrodes. It is noted that the data received from the frontal electrodes may also be referred to as ‘frontal electrode data’. The data on which the precordial lead is based may also be referred to as ‘precordial data’. It is furthermore noted that the term ‘providing’ is, in the context of this application, interchangeably used in several places with the word ‘registering’ with regard to the leads of the 12-lead ECG. It is preferred that the second right electrode (RL) and the second left electrode (LL) are positioned slightly lower than in the known methods for registering 12 leads for a 12-lead ECG. More preferably, the second right electrode (RL) and the second left electrode (LL) are positioned at or near opposite sides of the xyphoid. This provides a reference point that will serve to ensure reproducibility of consecutive leads (and ECGs based thereon) that are made using the method according to the invention. An advantage of the computer-implemented method according to the invention is that is allows registering one or more precordial leads for a 12-lead ECG without requiring precordial electrodes to obtain these precordial leads. This means that one or more precordial electrodes can be obviated using the method according to the present invention. As such, it is noted that the method is directed to determining at least one precordial lead based on data representing a measured voltage or voltage difference from at least one of four frontal electrodes. It is further noted that the four frontal electrodes need not be positioned on the limbs, yet may also be positioned on the chest at a relatively short distance from each other, such as in the range of 5 to 25 centimeter apart from each other. Another advantage is that, due to the precordial leads being determined based on one or more frontal electrodes, as little as four (frontal) electrodes are needed to obtain 12 leads for a 12-lead ECG. This decreases the number of electrodes needed, allowing a higher speed in obtaining the 12 leads. Yet another advantage, due to the low amount of electrodes needed, is that preparation time for registering the 12 leads is relatively low and at least significantly lower than in existing 12 lead ECGs. It is noted that the registration of the 12 leads is performed without loss of accuracy of the 12 leads. A further advantage is that the equipment required to register the 12 leads may be reduced in size, even to the point of providing a hand-held device for registering the 12 leads. An advantage of the computer-implemented method according to the invention, is that it allows the detection of rhythm disorders. In addition, due to the capability of providing 12 leads based on the frontal electrodes, the data representing the 12 leads is also sufficient for use in a 12-lead ECG that in turn can be used to detect occlusive myocardial infarction (OMI) in patients with chest pain. The latter has not been possible with the existing methods without the use of precordial electrodes. In an embodiment of the computer-implemented method according to the invention, the step of determining of the at least one precordial lead is performed exclusively based on the data representing the measured voltage or voltage difference from at least one of the frontal electrodes. It is preferred that at least one, preferably all, precordial leads are registered exclusively based on data from the frontal electrodes (i.e. without using precordial electrodes). This provides a maximum increase in speed and effectiveness without compromising on accuracy of the registration of the 12 leads. In an embodiment of the computer-implemented method according to the invention, the step of determining of the at least one precordial lead comprises determining six precordial leads, wherein the determining of each of the six precordial leads is performed exclusively based on the data representing the measured voltage or voltage difference from the frontal electrodes. To rapidly register all 12 leads for a 12 lead ECG, it is preferred that all precordial leads are registered exclusively based on data from the frontal electrodes. This obviates the use of precordial electrodes and may reduce the number of required electrodes to as little as four electrodes. To that end, the precordial leads are determined differently than presently performed in the traditional 10-electrode method or the EASI-method for determining (part of) the precordial leads. In particular, it is noted that the EASI-method can not be used to determine all precordial leads without adding further electrodes. In this embodiment of the computer-implemented method according to the invention, the precordial leads are determined on the basis of the following data. A precordial lead is determined on the basis of data representing a measured potential of the first right frontal electrode (RA) minus a potential of the Wilson Central Terminal (WCT), which is defined as * value of first right frontal electrode (RA) + the value of the first left frontal electrode the value of the second left frontal electrode (LL)). In short, this can be summarized in the formula: This precordial lead V1 in a traditional ECG. A further precordial lead is determined on the basis of data representing a measured potential of the first left frontal electrode (LA) and data representing a measured potential of the first right frontal electrode (RA), which are summed and subsequently divided in half, followed by subtracting the data representing a potential of the Wilson Central Terminal (WCT). The WCT is defined as (the value of first right frontal electrode (RA) + the value of the first left frontal electrode + the value of the second left frontal electrode (LL)). In short, this can be summarized in the formula: This further precordial a representing precordial lead V2 in a traditional ECG. A further precordial lead is determined on the basis of data representing the measured potential of the first left frontal electrode (LA) minus the data representing a potential of the Wilson Central Terminal (WCT). The WCT is defined as (the value of first right frontal electrode (RA) + the value of the first left frontal electrode + the value of the second left frontal electrode (LL)). In short, this can be summarized in the formula: This further precordial lead a data representing precordial lead V3 in a traditional ECG.A further precordial lead is determined on the basis of data representing the measured potential of the first left frontal electrode (LA) and data representing a measured potential of the second left frontal electrode (LL), which are summed and subsequently divided in half, followed by subtracting the data representing a potential of the Wilson Central Terminal (WCT). The WCT is defined as (the value of first right frontal electrode (RA) + the value of the first left frontal electrode + the value of the second left frontal electrode (LL)). In short, this can be summarized in the formula: This further precordial lead region of the heart. It is noted that it therewith is a substitute for the data representing precordial lead V4 in a traditional ECG. A further precordial lead is determined on the basis of data representing the measured potential of the second left frontal electrode (LL) minus the data representing a potential of the Wilson Central Terminal (WCT). The WCT is defined as (the value of first right frontal electrode (RA) + the value of the first left frontal electrode + the value of the second left frontal electrode (LL)). In short, this can be summarized in the formula: This further precordial lead points towards the apicolateral region of the heart. It is noted that it therewith is a substitute for the data representing precordial lead V5 in a traditional ECG. A further precordial lead is determined on the basis of data representing the measured potential of the second right frontal electrode (RL) minus the data representing a potential of the Wilson Central Terminal (WCT). The WCT is defined as value of first right frontal electrode (RA) + the value of the first left frontal electrode (LA) + the value of the second left frontal electrode (LL)). In short, this can be summarized in the formula: Precordial lead C6 points towards the right ventricle. This also means that, when the negative of C6 (thus: -C6) is taken, the result points towards the upper lateral region of the heart’s left ventricle. It is noted that -C6 therewith is a substitute for the data representing precordial lead V6 in a traditional ECG. It is noted that, in particular when the second right electrode (RL) and the second left electrode (LL) are positioned at or near opposite sides of the xyphoid, the data representing the precordial leads of the method according to the invention is different from the data representing the precordial leads in the known methods. However, the data representing the precordial leads of the method according to the invention advantageously also provides all information that is also included in a 12-lead ECG obtained using the known methods. This allows the data to be used to determine (presence of) pathological conditions. In an embodiment of the computer-implemented method according to the invention, the step of determining of the at least one precordial lead comprises determining six precordial leads, wherein the determining of each of the six precordial leads is performed exclusively based on the data representing the measured voltage or voltage difference from the frontal electrodes according to the vectors shown in figure 1e. To obtain a value that is directed to the upper lateral region of the heart’s left ventricle, the vector C6 is reversed (to -C6). In an embodiment of the computer-implemented method according to the invention the at least one precordial lead is determined on the basis of data representing a measured absolute potential of the first right frontal electrode RA. Preferably, this is mentioned as the first precordial lead. An advantage of the abovementioned embodiment is that the data representing a measured absolute potential of the first right frontal electrode RA is comparable to the data obtained by using a precordial electrodes for measuring the fourth intercostal space to the right of the sternum of a patient. It is often also referred to as the first anterior lead. In an embodiment of the computer-implemented method according to the invention the least one precordial lead is determined on the basis of data representing a measured absolute potential of the first left frontal electrode LA. Preferably, this is mentioned as the second precordial lead. An advantage of the abovementioned embodiment is that the data representing a measured absolute potential of the first left frontal electrode LA is comparable to the data obtained by using a precordial electrodes for measuring the fourth intercostal space to the left of the sternum of a patient. It is often also referred to as the second anterior lead. In an embodiment of the computer-implemented method according to the invention the at least one precordial lead is determined on the basis of data representing a measured absolute potential of the second left frontal electrode LL. Preferably, this is mentioned as the third precordial lead. An advantage of the abovementioned data is that it represents comparable data as can be obtained by a precordial electrode positioned to register the third anterior lead, which is the same as the first anterior lead. In the abovementioned embodiments of the computer-implemented method according to the invention, the ground electrode in the data representing one or more precordial lead is defined as a Wilson Central Terminal (WCT), which can be expressed as ⅓ *( the value of RA + the value of LA + the value of LL) or is the second right frontal electrode RL in the data representing one or more precordial leads. All data representing a precordial lead require that the measured value is referenced to a ground (i.e. electric potential of zero), which in the abovementioned embodiments is provided by the second right frontal electrode RL or is defined by a Wilson Central Terminal. In an alternative embodiment, the computer-implemented method according to the invention, the number of electrodes is five, wherein the fifth electrode is a central electrode (CE) configured to function as ground electrode in the data representing one or more precordial leads. All data representing a precordial lead require that the measured value is referenced to a ground (i.e. electric potential of zero), which in the abovementioned embodiment is a central electrode (CE). An advantage of the central electrode is that it reduces the amount of noise in the data representing the one or more precordial leads. It is preferred that, when using a central electrode, the first right and left frontal electrodes (RA, LA) and the second left and right frontal electrodes (LL, RL) are positioned in a rectangular configuration. The central electrode (CE) is in this case positioned at the central point of the rectangle formed by the other electrodes RA, LA, LL, RL). In an embodiment of the computer-implemented method according to the invention the at least one precordial lead is determined on the basis of data representing a measured potential difference between the first left frontal electrode LA and the second left frontal electrode LL. Preferably, this is mentioned as the fourth precordial lead. An advantage of the abovementioned data is that it represents comparable data as can be obtained by a precordial electrode positioned to register the fourth anterior lead, which is the same as the second anterior lead. In an embodiment of the computer-implemented method according to the invention the at least one precordial lead is determined on the basis of data representing a measured potential difference between the first left frontal electrode LA and the second right frontal electrode RL. Preferably, this is mentioned as the fifth precordial lead. An advantage of the abovementioned data is that it represents comparable data as can be obtained by a precordial electrode positioned to register the first lateral lead, which is often also referred to as the fifth anterior lead. In an embodiment of the computer-implemented method according to the invention the at least one precordial lead is determined on the basis of data representing a measured absolute potential of the second right frontal electrode RL. Preferably, this is mentioned as the sixth precordial lead. An advantage of the abovementioned data is that it represents comparable data as can be obtained by a precordial electrode positioned to register the second lateral lead, which is often also referred to as the sixth anterior lead. In the abovementioned embodiment of the computer-implemented method according to the invention, the ground electrode in the data representing the mentioned precordial lead is defined as a Wilson Central Terminal (WCT), which can be expressed as the value of RA + the value of LA + the value of LL) or is the second left frontal in the data representing the mentioned precordial lead. The data representing a measured absolute potential of the second right frontal electrode RL to determine the precordial lead requires that the measured value is referenced to a ground (i.e. electric potential of zero). In the abovementioned embodiment, the ground is formed by the second left frontal electrode LL or is defined by a Wilson Central Terminal. In an alternative embodiment, the computer-implemented method according to the invention, the number of electrodes is five, wherein the fifth electrode is a central electrode (CE) configured to function as ground electrode in the data representing a measured absolute potential of the second right frontal electrode RL to determine the precordial lead. All data representing a precordial lead require that the measured value is referenced to a ground (i.e. electric potential of zero), which in the abovementioned embodiment is a central electrode (CE). An advantage of the central electrode is that it reduces the amount of noise in the data representing the one or more precordial leads. It is preferred that, when using a central electrode, the first right and left frontal electrodes (RA, LA) and the second left and right frontal electrodes (LL, RL) are positioned in a rectangular configuration. The central electrode (CE) is in this case positioned at the central point of the rectangle formed by the other electrodes RA, LA, LL, RL). It is noted that the abovementioned embodiments specifically describing one of the precordial leads may also be provided as the first to the sixth precordial lead. In an embodiment of the computer-implemented method according to the invention, the step of determining 12 leads for the 12-lead ECG further comprises determining one or more bipolar leads, wherein: ̵ a first bipolar lead is determined on the basis of data representing a measured voltage between the first left frontal electrode LA and the first right frontal electrode RA; and / or ̵ a second bipolar lead is determined on the basis of data representing a measured voltage between the first right frontal electrode RA and the second left frontal electrode LL; and / or ̵ a third bipolar lead is determined on the basis of data representing a measured voltage between the second left frontal electrode LL and the first left frontal electrode LA. An advantage of the method according to the invention is that the data representing a measured voltage or voltage difference from a number of electrodes that at least include frontal electrodes can also be used to determine the bipolar leads of a 12 lead ECG. This means that no additional electrodes are required beyond four frontal electrodes. It is noted that, if desired, it is possible to utilize more than four electrodes even though this is not required. A further advantage of the method according to the invention is that, due to the abovementioned number of electrodes, the time required to register 12 leads of the 12 lead ECG can be reduced significantly compared to the known methods for registering 12 lead ECGs. In an embodiment of the computer-implemented method according to the invention, the step of determining 12 leads for a 12-lead ECG further comprises the step of determining one or more augmented unipolar leads determined on the basis of data representing a measured absolute potential of the first left frontal electrode LA and / or the first right frontal electrode RA and / or the second left frontal electrode LL, wherein: ̵ a first augmented unipolar lead aVL is calculated using the formula: and / or ̵ a second augmented unipolar lead aVF is calculated using the formula: and / or ̵ a third augmented unipolar lead aVR is calculated using the formula: An advantage of the is that the data representing a measured voltage or voltage difference from a number of electrodes that at least include frontal electrodes can also be used to determine the augmented unipolar leads of a 12 lead ECG. This means that no additional electrodes are required beyond four frontal electrodes. It is noted that, if desired, it is possible to utilize more than four electrodes even though this is not required. A further advantage of the method according to the invention is that, due to the abovementioned number of electrodes, the time required to register 12 leads of a 12 lead ECG can be reduced significantly compared to the known methods for registering 12 lead ECGs. The invention further relates to a computer-implemented method for providing a 12- lead ECG, the method comprising: ̵ determining 12 leads using the computer-implemented method for providing 12 leads for a 12-lead ECG according to the invention; and ̵ combining the 12-leads into an ECG, preferably into a graphic representation of the ECG, more preferably a graphic representation of the ECG according to the Cabrera system. An advantage of the abovementioned computer-implemented method is that, due to the effective determination of the 12 leads, an ECG with a high amount of sensitivity and accuracy can be provided. It is noted that the method according to the invention is particularly useful in detecting ischemic ST-segment deviations from different coronary artery culprits, which can not be achieved with single-lead ECG wearables, such as the Apple Watch. Such wearables have been found not useful for detection of ischemic ST-segment deviations from different coronary artery culprits as their single lead design leads to a sensitivity that is insufficiently high. Workarounds have been proposed, but these have been found to be too time-consuming and complicated for real-world use. It is noted that the computer-implemented method for providing a 12-lead ECG as described above may alternatively also be performed using standard ECG-recording methods instead of the computer-implemented method for providing 12 leads for a 12-lead ECG. This alternative may also be used in conjunction with one or more of the embodiments mentioned below. In an embodiment of the computer-implemented method according to the invention, the 12-lead ECG may be a personalized ECG and wherein the method further comprises detecting patient specific anomalies in the ECG for personalizing the ECG and outputting the information to a computing device and / or a memory. This embodiment allows patient specific anomalies, which are also present in a normal situation (i.e. a situation in which no pathological conditions are present), to be disregarded as indicators or markers for pathological conditions that need immediate (medical) attention.It is noted that, to perform the method according to the invention, only the data representing the 12 leads, or the data representing the ECG that is based on that data, is required. This also means that the presence of the patient from which the received data were obtained is not required to be present. In fact, the collection of the data is not part of the method.In an embodiment of the computer-implemented method according to the invention, the method may further comprise the steps of receiving data comprising at least one reference 12-lead ECG at a first time and storing the data comprising at least one reference 12-lead ECG in a memory. An advantage of providing and storing data representing a reference 12-lead ECG is that the data can be used at any subsequent time or point in time as a reference or basis for a comparison. The data representing the reference ECG preferably provides a reference ECG of the person that is made at a first time point. The first time point is a time point at which the person does not have any complaints and / or does not have any pathological (heart) conditions. As such, it forms a base line. The data representing the at least one reference ECG preferably comprises data representing three or more reference ECG’s, which include a reference ECG of the person sitting, a reference ECG of the person standing and a reference ECG of the person lying down. It has been found that this, especially when the reference ECGs are combined in a single reference ECG, provides a high reliability and sensitivity. The three ECGs in the different positions are generally all made on the first time. It is noted that where a time or time point is mentioned, this may also be considered a first time period of predetermined length. Generally, the various time periods do not overlap. It is noted that, to perform the method according to the invention, only the data representing the 12 leads, or the data representing the ECG that is based on that data, is required. This also means that the presence of the patient from which the received data were obtained is not required to be present. In an embodiment of the computer-implemented method according to the invention, the method may further comprise the steps of: ̵ receiving comparison data representing 12-lead ECGs from a database; ̵ comparing, using a processor and preferably using a neural network, the data representing the determined at least one reference 12-lead ECG with the comparison data to identify person-specific ECG-markers, wherein the person-specific ECG-markers are deviations of the data representing the at least one reference 12-lead ECG relative to the received comparison data; and ̵ storing the person-specific ECG-markers in a memory, and ̵ optionally, outputting an overview of the person specific ECG-markers to an external device, such as a computing device or a remote memory. An advantage of the abovementioned embodiment is that it provides a personalization of the received data and, in particular, the data representing the ECGs. This may advantageously serve two purposes. Firstly, the identification and storing of person-specific ECG-markers allows these markers to be considered irrelevant in data representing subsequent ECGs, for example data representing subsequent ECGs in which pathological conditions are evaluated. By ignoring or removing the known conditions, the analysis may be focused on deviations that, up to the time point that the subsequent ECG was made, were not known. Secondly, the data may, under certain predetermined conditions, such as legal allowability, also be used for research purposes, for example to further and / or more accurately understand the relationship between a pathological condition and a deviation in data representing the ECG. It is noted that the step of storing the person-specific ECG-markers in a memory may comprise the step of storing the person-specific ECG-markers as part of a personal ECG. In this case the person-specific ECG-markers are part of ECG that is stored in the memory, for example for later use. The abovementioned steps of receiving, comparing and storing are performed on the received data representing the ECG. These steps may be performed before storing the data representing at least one reference ECG in a memory or may be performed after the at least one reference ECG has been stored in the memory. In the latter case, it is preferred that the data representing the ECG is retrieved from the memory in order to be able to perform the step of comparing on said data. In an embodiment of the computer-implemented method according to the invention, the method may further comprise the steps of: ̵ receiving data representing at least one subsequent 12-lead ECG at a subsequent time; ̵ storing the data representing the at least one subsequent 12-lead ECG in the memory; ̵ upon receiving the data representing the at least one subsequent 12-lead ECG, comparing, using a processor and preferably using a neural network, the data representing the subsequent 12-lead ECG with the data representing at least one of the at least one reference 12-lead ECGs stored in the memory to identify deviations between the subsequent 12-lead ECG and data representing the at least one reference 12-lead ECG; ̵ outputting the identified deviations to an external source, such as a computing device or a user interface for further review; and ̵ optionally storing the identified deviations in the memory. An advantage of the abovementioned embodiment is that it allows the presence and / or (further) development of any known (pathological) conditions or heart disorders to be followed in a consistent and reliable manner. The subsequent ECG is thereto made at a subsequent time, for example at a second time that is later than the first time. The development can be identified by identifying and / or tracking changes in the person-specific ECG-markers, which changes may be outputted to a computing device or memory for later use by a medical professional or, in some embodiments, even an automated evaluation system. Another advantage is that the person-specific markers, if not changed at the subsequent time, will be removed in the comparison between the reference ECG and the subsequent ECG. As a result, only deviations that are not person-specific markers will remain and can be evaluated. The abovementioned steps are performed on the received data representing the ECG. These steps may be performed before storing the data representing at least one reference ECG in a memory or may be performed after the at least one reference ECG has been stored in the memory. In the latter case, it is preferred that the data representing the ECG is retrieved from the memory in order to be able to perform the step of comparing on said data. In an embodiment according to the invention, the method may optionally include one or more of the steps of comparing, the subsequent 12-lead ECG with one or more preceding subsequent ECGs and coupling the identified deviations stored in the memory to the subsequent 12-lead ECG from which they were derived. An advantage of coupling the deviations with the subsequent ECG in which these deviations were detected allows easy retrieval of both the source data (representing the ECG) and the deviations that emerge after comparing. In some embodiments, the deviations may be included in a modified ECG that includes the changes. In an embodiment of the computer-implemented method for providing a 12-lead ECG according to the invention, the method further comprises the step of, based on the outputted identified deviations, diagnosing, preferably automatically diagnosing, whether the deviations are indicative of a pathological condition. The deviations may according to the method be automatically diagnosed in order to provide an indication on whether a pathological condition is present. This may provide the person using the ECG (i.e. a patient) with a direct indication of whether the deviation is a reason for concern and requires a medical specialist to be contacted and / or action to be taken. In an embodiment of the computer-implemented method according to the invention, the method may further comprise the steps of: ̵ comparing, using a processor, and preferably using a neural network, the data representing the at least one subsequent ECG with the comparison data to identify general markers, wherein the general markers are deviations of the data representing the at least one subsequent ECG relative to the comparison data; ̵ comparing the general markers with person-specific ECG-markers; ̵ removing any general markers that match a person-specific ECG-marker; ̵ identifying any anomalies in the data representing the at least one subsequent 12-lead ECG, if any, wherein the anomalies are any general markers remaining after the steps of comparing and removing; and ̵ outputting, to a computing device or an external memory, data representing at least the anomalies and / or storing in a memory, data representing at least the anomalies. It is noted that comparison data may contain data representing normal and / or abnormal ECGs from a database. The data representing a normal ECG may include an ECG that it is known to contain no specific pointers that indicate a pathological (heart) condition, whereas data representing abnormal ECGs may contain one or more deviations or pointers that indicate that a pathological condition of the heart may be present. The deviations or pointers are generally deviations that are known to be (likely) connected to a pathological condition. The abovementioned embodiment provides several advantages. First of all, the identification and subsequent removal of the person-specific ECG-markers in the data representing the subsequent ECG allows any subsequent analysis of the data to be focused on general markers that, up to the time point that the subsequent ECG was made, were not known. Another advantage is that the heart condition of a person, including any deviations, can be monitored in a consistent manner over a longer period of time due to the fact that the data representing this heart condition (i.e. the data representing the ECGs) is stored in a memory. A further advantage is that, when the anomalies are outputted to a computing device, these may be used for early detection of a pathological condition in that particular computing device. This will require additional diagnostic steps, which may for example be incorporated in the computing device. An even further advantage is the data collection, by means of the storage in memory, can be used for research purposes as it represents a consistent and reliable measurement over a longer period of time. At present, such long-time monitoring is not performed. This is mainly due to the fact that providing a 12-lead ECG requires complex equipment only available in hospitals and care centers. In an embodiment of the computer-implemented method for providing a 12-lead ECG according to the invention, the step of removing any deviations that match a person-specific ECG-marker comprises removing any deviations from the at least one subsequent ECG to provide data representing a person-specific subsequent ECG. Advantageously, the data representing each of the subsequent ECGs is subjected to the step of removing deviations and is subsequently outputted as data representing a person- specific subsequent ECG. This allows the person-specific subsequent ECGs to be compared with each other in a later stage for one or more purposes. In an embodiment of the computer-implemented method for providing a 12-lead ECG according to the invention, the method may comprise the step of providing the anomalies as part of a person-specific subsequent ECG to provide data representing a modified person- specific subsequent ECG. The data representing the person-specific subsequent ECG may advantageously be processed further data representing a modified person-specific subsequent ECG. This particular data includes the anomalies and may for example be used as basis for an analysis by a medical professional or medical specialist. In an embodiment of the computer-implemented method for providing a 12-lead ECG according to the invention, the step of outputting may comprise the step of outputting the modified person-specific subsequent ECG to a computing device or a memory. The data representing a modified person-specific subsequent ECG may also be provided to a computing device for automatic analysis by software configured to identify pathological conditions. It may also be provided to a memory, such as a digital patient dossier or file, to provide a reliable and consistent overview in time of the heart condition of the person (i.e. patient) to which the data relates. The abovementioned embodiments of the method are performed on the received data representing the ECG and may be performed either before storing said data representing an ECG in a memory or after said data representing the ECG has been stored in the memory. In the latter case, it is preferred that the data representing the ECG is retrieved from the memory in order to be able to perform the step of comparing on said data. It is further noted that the embodiments as described above and that relate to the personalisation of one or more ECGs, such as by identifying one or more of person-specific ECG-markers, deviations or general markers, may also be performed on data representing an ECG that has been collected using a prior art method for performing an ECG. It is noted that these embodiments may be the subject of a divisional application which is not limited to the combination with the computer-implemented method for determining 12 leads for a 12-lead ECG as also described in this application. In an embodiment of the computer-implemented method according to the invention, the method may further comprise the steps of: ̵ performing at least one fingerprint 12-lead ECG at a first time; ̵ performing at least one subsequent 12-lead ECG at a subsequent time; ̵ comparing, preferably using a neural network, the subsequent 12-lead ECG with at least one of the at least fingerprint 12-lead ECGs; and ̵ identifying, preferably using a neural network, whether the subsequent 12-lead ECG deviates from the one or more preceding 12-lead ECGs with respect to one or more predetermined parameters; ̵ optionally processing the differences, wherein processing may comprise one or more of: ̵ storing the identified differences in a memory; ̵ outputting the identified differences to an external source, such as a user interface. It is noted that the term fingerprint ECG is meant to be identical to the term reference ECG, which is an ECG that is made as a reference point that can be used for any comparison with subsequent ECGs. An advantage of the abovementioned embodiment is that the subsequent ECGs are checked for pathological conditions (i.e. coronary diseases or conditions) based on a personalized ECG. As a result, some anomalies that would have been identified as possible problem, are disregarded since they were also already present in the ‘normal situation’ as presented by the fingerprint ECG. As a result, a more detailed and personalized approach is made to the ECG, thus increasing the safety of the patient. The abovementioned embodiment may optionally include one or more of the steps of comparing, the subsequent 12-lead ECG with one or more preceding subsequent ECGs and / or the step of storing each determined 12-lead ECG in a memory. In an embodiment of the computer-implemented method according to the invention, the method may further comprise the steps of: ̵ receiving comparison data representing normal and / or abnormal ECGs from a database; ̵ comparing, preferably using a neural network, the comparison data with the data representing the determined at least one fingerprint 12-lead ECG; ̵ identifying, preferably using a neural network, differences between the data representing the determined at least one fingerprint 12-lead ECG and the received comparison data; ̵ marking, and preferably storing in a memory, the identified differences as personalized ECG markers that are not anomalies; and ̵ optionally, outputting anomaly data containing the determined differences. An advantage of the abovementioned embodiment is that deviations or anomalies that are present in a patient, for example due to a known heart condition, can be disregarded as anomalies that require action based on the ECG. In other words, the specificity of the ECG is increased due to the personalization of the ECG using markers. Another advantage is that the markers can easily be retrieved by a patient or medical professional for review, for example if the patient is assisted by a professional who is not his regular doctor. In an embodiment of the computer-implemented method for providing a 12-lead ECG according to the invention, the method may further comprise the steps of: ̵ benchmarking, preferably using a neural network, the determined at least one fingerprint 12-lead ECG with the received comparison data for classifying the determined 12-lead ECG as normal or abnormal; ̵ if the determined 12-lead ECG is classified as abnormal, comparing the determined fingerprint 12-lead ECG with the normal ECGs from the comparison data to determine the differences; ̵ removing any differences that are marked as personalized ECG markers from the identified differences, ̵ marking any remaining differences, if any, as an anomaly in the determined subsequent 12-lead ECG; and ̵ if an anomaly is marked, outputting data representing anomaly information. An advantage of this embodiment is that, when comparing the ECG with a benchmarking group, such as a comparison group, the personalized markers can be used to disregard differences that otherwise would have been marked as anomaly. In an embodiment of the computer-implemented method for providing a 12-lead ECG according to the invention, the method may further comprise the steps of: ̵ receiving the comparison data representing normal and / or abnormal ECGs from a database; ̵ identifying, preferably using a neural network, differences between the one or more subsequent ECGs and the comparison data; ̵ removing any differences that are marked as personalized ECG markers from the identified differences, ̵ marking any remaining differences, if any, as an anomaly in the determined subsequent 12-lead ECG; and ̵ if an anomaly is marked, outputting data representing anomaly information. An advantage of this embodiment is that, when comparing the ECG with a benchmarking group, such as a comparison group, the personalized markers can be used to disregard differences that otherwise would have been marked as anomaly. Another advantage of the abovementioned embodiment is that deviations or anomalies that are present in a patient, for example due to a known heart condition, can be disregarded as anomalies that require action based on the ECG. In other words, the specificity of the ECG is increased due to the personalization of the ECG using markers. It is noted that the computer-implemented method for providing a 12-lead ECG as described above may alternatively also be performed using standard ECG-recording methods instead of the computer-implemented method for providing 12 leads for a 12-lead ECG. This alternative may also be used in conjunction with one or more of the embodiments mentioned in relation to the computer-implemented method for providing a 12-lead ECG. The invention further relates to a 12-lead ECG-device configured for measuring a 12- lead ECG, the device having means adapted to execute the method according to the invention. The device according to the invention has similar effects and advantages as the method according to the invention. The embodiments disclosed in relation to any one of the claims or embodiments of the method can also be, alone or in combination, be applied to the device according to the invention. In an embodiment of the device according to the invention, the means comprise: ̵ a computing device; and ̵ at least four electrodes that are configured to be positioned on a user’s body and that are operatively connected to the computing device, wherein the four electrodes comprise frontal electrodes, wherein the frontal electrodes comprise: ̵ a right frontal electrode RA that is configured to be placed on a right frontal of a user; ̵ a left frontal electrode LA that is configured to be placed on a left frontal of a user; ̵ a left frontal electrode LL that is configured to be placed on a left frontal of a user; and ̵ a right frontal electrode RL that is configured to be placed on a right frontal of a user. An advantage of the abovementioned means is that a reliable ECG with sufficient sensitivity can be registered using a relatively small device. The device according to the invention allows a person to monitor his / her own heart condition at home without the assistance of a medical professional. An advantage thereof is that, especially when the results are stored, a more consistent, long-term and reliable monitoring of the heart condition becomes possible to identify any developments and / or (indicators of) pathological conditions at an early stage. It is preferred that the device, during use, is positioned on the sternum in a rectangular position using the xyphoid as a reference point. Not only does this positioning serve to ensure reproducibility of consecutive ECGs made using the device, it also provides a clear reference point which provides easy access to left and right frontal positions. In an embodiment of the 12-lead ECG-device according to the invention, the at least four electrodes are four electrodes. It has been found that the use of (exactly) four electrodes in the device is sufficient to provide data representing a 12-lead ECG. As a result, the device can be kept compact and easy to use, especially when compared to the known devices used in hospitals and care centers. In an embodiment of the 12-lead ECG-device according to the invention, the four electrodes are positioned in a rectangular pattern (i.e. one electrode on each corner of a rectangle), and preferably a distance between the electrodes is in the range of 5 to 25 centimeters, more preferably in the range of 5 to 20 centimeters and even more preferably in the range of 5 to 15 centimeters. It is further preferred that a distance measured along a longitudinal side of the rectangle is larger than a distance measured along a lateral side of the rectangle. It has been found that, by using four electrodes, preferably frontal electrodes, the four electrodes do not necessarily have to be connected to the limbs of a patient to be able to obtain data representing the 12 leads. In fact, it has been found that by maintaining a distance between the electrodes in the abovementioned ranges, the data representing the 12 leads of the 12-lead ECG is sufficiently accurate and sensitive to be able to obtain a 12-lead ECG therefrom. It is preferred that the device, during use, is positioned on the sternum in a rectangular position using the xyphoid as a reference point. Although this is not a necessity, such positioning will serve to ensure reproducibility of consecutive ECGs made using the device. In an embodiment of the 12-lead ECG-device according to the invention, the computing device may be configured for: ̵ receiving data representing a measured electrical potential from at least the frontal electrodes; ̵ determining, from the received data, 12 leads for a 12-lead ECG, wherein the step of determining comprises: ̵ determining at least one precordial lead based on the data representing a measured electrical potential from at least one of the frontal electrodes. The invention further relates to a computer program comprising instructions that, when the program is carried out by a computer, cause the computer to execute the method of the invention. The computer program according to the invention has similar effects and advantages as the method and the device according to the invention. The embodiments disclosed in relation to any one of the claims or embodiments of the method or the device can also be, alone or in combination, be applied to the computer program according to the invention. The invention further relates to a computer-readable storage medium having stored thereon the computer program according to the invention. The computer-readable storage medium according to the invention has similar effects and advantages as the method, the device and the computer program according to the invention. The embodiments disclosed in relation to any one of the claims or embodiments of the method, the device and / or the computer program can also be, alone or in combination, be applied to the computer-readable storage medium according to the invention. Further advantages, features and details of the invention are elucidated on the basis of preferred embodiments thereof, wherein reference is made to the accompanying drawings, in which: Figures 1a, 1b show a perspective view of an example of a device according to the invention; Figure 1c shows a schematic view of an example of data, in the form of vector representations, with the data representing the 12 leads of an ECG as provided according to the prior art; Figure 1d shows a schematic view of an example of data, in the form of vector representations, with the data representing the 12 leads of an ECG as provided according to the invention; Figure 1e shows a schematic view of an example of data, in the form of vector representations, with the data representing the precordial leads of an ECG as provided according to the invention; Figure 2a shows a perspective view of the example of figure 1, when used to collect data representing a measured voltage or voltage difference; Figure 2b shows an example of data representing the measured electric potential for the various leads according to figure 2a; Figure 3a is an example of a comparison of data representing a known 12-lead ECG and an example of data representing an ECG of the method according to the invention; Figure 3b shows an example of data representing an ECG that is made using the method according to the invention; Figure 4a shows a schematic overview of a computing device displaying several aspects that may be used as input when generating the data representing an ECG; Figure 4b shows an example of the data representing the ECG as can be displayed on a screen of the computing device; Figure 5 shows a schematic overview of an example of the computer-implemented method for providing 12 leads for a 12-lead ECG according to the invention; and Figure 6 shows a schematic overview of an example of the computer-implemented method for providing a 12-lead ECG according to the invention. In an example of device 2 according to the invention (see figure 1a, 1b), device 2 comprises housing 4, which in this example is made of plastic. Housing 4 has upper housing part 6 and lower housing part 8, both of which are substantially shaped as a rounded-off rectangular. Housing 4 extends over length L in first direction x and over width W in second direction y, which is perpendicular to first direction x. In this example, upper housing part 6 is slightly smaller in both length and width as lower housing part 8 to allow device 2 to be gripped (more easily) by a user. Upper housing part 6 is further provided with on / off switch 10 and indicator lights 12, 14 that, in this example, provide information on connectivity 14 and on battery status 12. Upper housing part 14 further comprises recording button 16, which in this example is positioned below progress indicator 18. Progress indicator 18 in this example comprises a number of lights that can light up sequentially to indicate the progress of collecting data. Lower housing part 18 comprises four electrodes 20, 22, 24, 26 (see also figure 1b) that are positioned near respective corners 28, 30, 32, 34 of lower housing part 18. When viewed in third direction z, which is perpendicular to first direction x and second direction y, electrodes 20, 22, 24, 26 project from bottom surface 36 of housing 4 to allow electrodes 20, 22, 24, 26 to be more easily be placed on a chest of a user / patient. In use of device 202, device 202 is placed on the chest of person P (see figure 2a) such that electrodes 222, 224, 226, 228 are positioned over heart H of person P. After pressing recording button 216, device 202 starts collecting data representing the various leads of the 12-lead ECG using to the methods according to the invention. In the present example, data representing measurement of six precordial leads S1, A2, L2, I1, I2, I3 are shown based using frontally placed electrodes 222, 224, 226, 228. The data representing the measured electric potential for the various leads is shown in figure 2b. In the example (see figure 3), data representing four leads on different locations is shown. The locations are the anterior, the antero-lateral, the inferior and the IPL / posterior positions. The difference between the prior art method for providing 12 leads for a 12-lead ECG and the computer-implemented method according to the invention is most clearly shown in figures 1c and 1d. Figure 1c shows providing 12 leads according to the prior art by using ten different electrodes. The ten electrodes include, as customary in the prior art, four extremity electrodes which are used to provide data representing the bipolar and unipolar leads. The customary electrodes further include six chest electrodes which are used to provide data representing the six precordial or chest leads. The precordial leads are generally indicated with V1 to V6 and (together) form data representing the depolarization wave of the heart viewed in the frontal plane. It can clearly be seen (see figure 1c) that each vector V1 to V6, that is data representing a precordial lead, is derived from a single chest electrode (each vector being related to a single one of these chest electrodes). Figure 1d shows providing 12 leads of the computer-implemented method according to the invention using only four electrodes. It can clearly be seen that data representing all leads, including the precordial leads, is provided using only four electrodes. In particular, the data representing the six precordial leads is derived from data obtained by (a combination of) one of more the four electrodes (RA, RL, LA, LL). Figure 1e shows that data representing precordial lead C1 is directed through first right frontal electrode RA and pointing outwardly from the WCT. Data representing precordial lead C2 is pointing outwardly from the WCT and extends through a point present about halfway between first right frontal electrode RA and first left frontal electrode LA. As shown in figure 1e, data representing precordial lead C3 is directed through first left frontal electrode (LA) and pointing outwardly from WCT. Data representing precordial lead C4 is pointing outwardly from WCT and extends through a point present about halfway between first left frontal electrode LA and second left frontal electrode LL. Data representing precordial lead C5 is and pointing outwardly from WCT and is directed through second left frontal electrode LL. Furthermore, data representing precordial lead C6 is pointing outwardly from WCT and directed through second right frontal electrode RL. In view of the above, figure 1e also shows that the data representing the various precordial leads C1 to C6, can be formulated in the following formulae: is defined as WCT (RA + LA + LL). The method according to the invention is, as is shown in figure 3b, to provide a 12- lead ECG with only four electrodes. In an example of computer-implemented method 1000 (see figure 5) for providing 12 leads for a 12-lead ECG, method 1000 may comprise the steps of receiving 1002 frontal electrode data representing a measured voltage or voltage difference from a number of electrodes that at least include frontal electrodes comprising a first right frontal electrode (RA), a first left frontal electrode (LA), a second left frontal electrode (LL) and a second right frontal electrode (RL) and determining 1004, from the received data, 12 leads for a 12-lead ECG. The step of determining comprises in this example the step of determining 1006 at least one precordial lead based on the data representing a measured voltage or voltage difference from at least one of the frontal electrodes. In this example, the determining of the at least one precordial lead consists of determining 1006a six precordial leads, each of which is performed exclusively based on the data representing the measured voltage or voltage difference from the frontal electrodes. This obviates the use of precordial electrodes and, in fact, makes it possible to obtain 12 leads using four (and only four) frontal electrodes. In particular, first precordial lead is determined 1012 on the basis of data representing a measured absolute potential of the first right frontal electrode RA and second precordial lead is determined 1014 on the basis of data representing a measured absolute potential of the first left frontal electrode LA. Third precordial lead is determined 1016 on the basis of data representing a measured absolute potential of the second left frontal electrode LL. In the mentioned data, second right frontal electrode RL is the ground electrode. Fourth precordial lead is determined 1018 on the basis of data representing a measured potential difference between the first left frontal electrode LA and the second left frontal electrode LL, whereas a fifth precordial lead is determined 1020 on the basis of data representing a measured potential difference between the first left frontal electrode LA and the second right frontal electrode RL. Finally, a sixth precordial lead is determined 1022 on the basis of data representing a measured absolute potential of the second right frontal electrode RL. In this case, second left frontal electrode LL is the ground electrode. Method 1000 in this example further comprises, in the step of determining 100412 leads for the 12-lead ECG, determining 1024 one or more bipolar leads, wherein a first bipolar lead is determined 1026 on the basis of data representing a measured voltage between the first left frontal electrode LA and the first right frontal electrode RA. A second bipolar lead is determined 1026 on the basis of data representing a measured voltage between the first right frontal electrode RA and the second left frontal electrode LL and a third bipolar lead is determined 1028 on the basis of data representing a measured voltage between the second left frontal electrode LL and the first left frontal electrode LA. The step of determining 100412 leads for a 12-lead ECG in method 1000 may further also comprise the step of determining 1032 one or more augmented unipolar leads determined on the basis of data representing a measured absolute potential of the first left frontal electrode LA and / or the first right frontal electrode RA and / or the second left frontal electrode LL. A first augmented unipolar lead aVL is calculated 1034 using the formula: A second augmented 1036 using the formula: A third augmented using the formula: It is also possible to determine, based on the data, to determined one or several of the mentioned leads. In other words, step 1004 may include a single step of the steps 1012 to 1038 or may include several or all steps 1012 to 1038. In any case, method 1000 always includes at least one of the steps 1012 to 1022. In an example of computer-implemented method 2000 for providing a 12-lead ECG (see figure 6), the method in this example comprises the steps of determining 200412 leads using steps 1012 to 1038 of method 1000 and combining 2040 the 12-leads into an ECG, preferably into a graphic representation of the ECG, more preferably a graphic representation of the ECG according to the Cabrera system. Method 2000 may further also comprise the optional steps of receiving 2042, at a first time, data representing at least one reference 12-lead ECG and storing 2044 the data representing at least one reference 12-lead ECG in a memory. Further optionally, method 2000 may also include the steps of receiving 2045 comparison data representing 12-lead ECGs from a database and automatically comparing 2046, using a processor and preferably using a neural network, the data representing the determined at least one reference 12-lead ECG with the comparison data to identify deviations of the data representing the at least one reference 12-lead ECG relative to the received comparison data. Subsequent optional steps are marking 2048 the identified deviations as person-specific ECG-markers, storing 2050 the person-specific ECG-markers in a memory, and optionally, outputting 2052 an overview of the person specific ECG-markers to an external device, such as a computing device or a remote memory. Method 2000 may further comprise the optional steps of receiving 2054, at a subsequent time, data representing at least one subsequent 12-lead ECG and storing 2056 the data representing the at least one subsequent 12-lead ECG in the memory. Upon receiving 2054 the data representing the at least one subsequent 12-lead ECG, the optional step of automatically comparing 2058, using a processor and preferably using a neural network, the data representing the subsequent 12-lead ECG with the data representing at least one of the at least one reference 12-lead ECGs stored in the memory to identify deviations between the data representing the subsequent 12-lead ECG and the data representing the at least one reference 12-lead ECG. Subsequent optional steps in method 2000 are outputting 2060 the identified deviations to an external source, such as a computing device or a user interface for further review and / or storing 2062 the identified deviations in the memory. Method 2000 optionally further comprises the steps of comparing 2064, using a processor, and preferably using a neural network, the data representing the at least one subsequent ECG with the comparison data to identify deviations of the data representing the at least one subsequent ECG relative to the comparison data. To that end, data representing the at least one subsequent ECG is obtained from step 2054. The optional method steps further include the step of comparing 2066 the identified deviations with person-specific ECG- markers and removing 2068 any deviations that match a person-specific ECG-marker. The person-specific markers are obtained in this example from step 2048. Further optionally, method 2000 includes the step of identifying 2070 any remaining deviations, if any, and marking each of said remaining deviations as an anomaly in the at least one subsequent 12- lead ECG and outputting 2072, to a computing device or an external memory, data representing at least the anomalies and / or storing in a memory, data representing at least the anomalies. In an example (see figure 4a), a computing device is used to display data obtained using the computer-implemented method according to the invention. The computing device, for example a smart phone, may display data representing information about a user of device 2, 202 according to the invention. Additionally or alternatively, a computing device may also be used to display a graphic representation of the ECG after combining these 12 leads into an ECG using method 2000 according to the invention (see figure 4b). It is noted that, although the different reference letters are used, the data representing the ECG in figure 2b is similar (though not identical) to the data representing the ECG in figure 4b. In particular, the data representing the various ECG-leads in figure 2b is similar to the data representing the various ECG-leads in figure 4b according to the following structure. Data A1 is similar to data I, data A2 is similar to data II, data S1 is similar to data C1, data A2 is (also) similar to data C2, data L2 is similar to data C3, data I1 is similar to data C4, data I2 is similar to data C5 and data I3 is similar to data C6. The present invention is by no means limited to the above described preferred embodiments and / or experiments thereof. The rights sought are defined by the following claims within the scope of which many modifications can be envisaged.

Claims

AMENDED CLAIMS received by the International Bureau on 10 June 2025 (10.06.2025).1 . Computer-implemented method for providing 12 leads for a 12-lead ECG, the method comprising: receiving data representing a measured voltage or voltage difference from a number of electrodes that at least include frontal electrodes comprising a first right frontal electrode (RA), a first left frontal electrode (LA), a second left frontal electrode (LL) and a second right frontal electrode (RL); determining, from the received data, 12 leads for a 12-lead ECG, wherein the step of determining comprises determining six precordial leads, and wherein the determining of each of the six precordial leads is performed exclusively based on the data representing the measured voltage or voltage difference from the frontal electrodes.

2. Method according to claim 1 , wherein: a first precordial lead is determined on the basis of data representing a measured potential of the first right frontal electrode (RA) minus the data representing a potential of the Wilson Central Terminal (WCT); and a second precordial lead is determined on the basis of data representing a measured potential of the first left frontal electrode (LA) and data representing a measured potential of the first right frontal electrode (RA), which are summed and subsequently divided in half, followed by subtracting the data representing a potential of the Wilson Central Terminal (WCT); and a third precordial lead is determined on the basis of data representing the measured potential of the first left frontal electrode (LA) minus the data representing a potential of Wilson Central Terminal (WCT); and a fourth precordial lead is determined on the basis of data representing the measured potential of the first left frontal electrode (LA) and data representing the measured potential of the second left frontal electrode (LL), which are summed and subsequently divided in half, followed by subtracting the data representing a potential of the Wilson Central Terminal (WCT); and a fifth precordial lead is determined on the basis of data representing the measured potential of the second left frontal electrode (LL) minus the data representing a potential of the Wilson Central Terminal (WCT); and a sixth precordial lead is determined on the basis of data representing the measured potential of the second right frontal electrode (RL) minus the data representing a potential of the Wilson Central Terminal (WCT).

3. Method according to claim 1 , wherein: a first precordial lead is determined on the basis of data representing a measured absolute potential of the first right frontal electrode RA; and a second precordial lead is determined on the basis of data representing a measured absolute potential of the first left frontal electrode LA; and a third precordial lead is determined on the basis of data representing a measured absolute potential of the second left frontal electrode LL; and a fourth precordial lead is determined on the basis of data representing a measured potential difference between the first left frontal electrode LA and the second left frontal electrode LL; and a fifth precordial lead is determined on the basis of data representing a measured potential difference between the first left frontal electrode LA and the second right frontal electrode RL; and a sixth precordial lead is determined on the basis of data representing a measured absolute potential of the second right frontal electrode RL.

4. Computer-implemented method according to claim 2 or 3, wherein in the data representing the sixth precordial lead the second left frontal electrode LL is the ground electrode, and wherein the second right frontal electrode RL is the ground electrode in the data representing the first, second and third precordial leads.

5. Computer-implemented method according to any one of the preceding claims, wherein the step of determining 12 leads for the 12-lead ECG further comprises determining one or more bipolar leads, wherein: a first bipolar lead is determined on the basis of data representing a measured voltage between the first left frontal electrode LA and the first right frontal electrode RA; a second bipolar lead is determined on the basis of data representing a measured voltage between the first right frontal electrode RA and the second left frontal electrode LL; a third bipolar lead is determined on the basis of data representing a measured voltage between the second left frontal electrode LL and the first left frontal electrode LA.

6. Computer-implemented method according to any one of the preceding claims, wherein the step of determining 12 leads for a 12-lead ECG further comprises the step of determining one or more augmented unipolar leads determined on the basis of data representing a measured absolute potential of the first left frontal electrode LA and / or the first right frontal electrode RA and / or the second left frontal electrode LL, wherein: a first augmented unipolar lead aVL is calculated using the formula:and / or a second augmented unipolar lead aVF is calculated using the formula:and / or a third augmented unipolar lead aVR is calculated using the formula:

7. Computer-implemented method according to any one of the preceding claims, wherein the determining of each of the six precordial leads is performed exclusively based on the data representing the measured voltage or voltage difference from the frontal electrodes as is illustrated in figure 1 e of the drawings.

8. Computer-implemented method for providing a 12-lead ECG, the method comprising: determining 12 leads using the computer-implemented method according to any one of the preceding claims; and combining the 12 leads into an ECG, preferably into a graphic representation of the ECG, more preferably a graphic representation of the ECG according to the Cabrera system.

9. Computer-implemented method according to claim 8, wherein the 12-lead ECG is a personalized ECG, and wherein the method further comprises detecting patient specific anomalies in the ECG for personalizing the ECG and outputting the information to a computing device and / or a memory.

10. Computer-implemented method according to claim 8 or 9, further comprising the steps of: receiving data representing at least one reference 12-lead ECG at a first time, wherein the data representing the at least one reference 12-lead ECG are obtained using the method of claim 9; storing the data comprising at least one reference 12-lead ECG in a memory.1 1 . Computer-implemented method according to claim 10, further comprising the steps of: receiving comparison data representing 12-lead ECGs from a database; comparing, using a processor and preferably using a neural network, the data representing the determined at least one reference 12-lead ECG with the comparison data to identifyperson-specific ECG-markers, wherein the person-specific ECG-markers are deviations of the data representing at least one reference 12-lead ECG relative to the received comparison data; and storing the person-specific ECG-markers in a memory, and optionally, outputting an overview of the person specific ECG-markers to an external device, such as a computing device or a remote memory.

12. Computer-implemented method according to claim 10 or 1 1 , further comprising the steps of: receiving data representing at least one subsequent 12-lead ECG at a subsequent time wherein the data representing the at least one subsequent 12-lead ECG are obtained using the method of claim 8; storing the data representing the at least one subsequent 12-lead ECG in the memory; upon receiving the data representing the at least one subsequent 12-lead ECG, comparing, using a processor and preferably using a neural network, the subsequent 12- lead ECG with data representing at least one of the at least one reference 12-lead ECG stored in the memory to identify deviations between data representing the subsequent 12- lead ECG and data representing the at least one reference 12-lead ECG; outputting the identified deviations to an external source, such as a computing device or a user interface; and optionally storing the identified deviations in the memory.

13. Computer-implemented method according to claim 12, when dependent on claim 1 1 , further comprising the steps of: comparing, using a processor, and preferably using a neural network, the data representing at least one subsequent ECG with the comparison data to identify general markers, wherein the general markers are deviations of the data representing the at least one subsequent ECG relative to the comparison data; comparing the general markers with person-specific ECG-markers; removing any general markers that match a person-specific ECG-marker; identifying anomalies in the data representing the at least one subsequent 12-lead ECG , if any, wherein the anomalies are any deviations remaining after the steps of comparing and removing; and outputting, to a computing device or an external memory, data representing at least the anomalies and / or storing in a memory, data representing at least the anomalies.

14. An 12-lead ECG-device configured for measuring a 12-lead ECG, the device having means adapted to execute the method according to any one of the claims 1 - 7 or the method according to any one of the claims 8 - 13.

15. The 12-lead ECG-device according to claim 14, wherein the means comprise: a computing device; and at least four electrodes that are configured to be positioned on a user's body and that are operatively connected to the computing device, wherein the four electrodes comprise frontal electrodes, wherein the frontal electrodes comprise: a right frontal electrode RA that is configured to be placed on a right frontal of a user; a left frontal electrode LA that is configured to be placed on a left frontal of a user; a left frontal electrode LL that is configured to be placed on a left frontal of a user; and a right frontal electrode RL that is configured to be placed on a right frontal of a user.

16. The 12-lead ECG-device according to claim 15, wherein the at least four electrodes are four electrodes.

17. The 12-lead ECG-device according to claim 15 or 16, wherein the computing device is configured for: receiving data representing a measured electrical potential from at least the frontal electrodes; determining, from the received data, 12 leads for a 12-lead ECG, wherein the step of determining comprises: determining at least one precordial lead based on the data representing a measured electrical potential from at least one of the frontal electrodes.

18. Computer program comprising instructions that, when the program is carried out by a computer, cause the computer to execute the method of any one of the preceding method claims.

19. Computer-readable storage medium having stored thereon the computer program of claim 18.

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