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Peer-Reviewed Publication
J Electrocardiol2026;95154204.January 1, 2026Journal Article

Toward self-validating ECG Systems: A personalized, uncertainty-aware approach for detecting and estimating lead misplacement.

Alireza Rafiei1, Trisha Dwivedi2, Joel Xue3, Daphne E Schlesinger4, Nasim Katebi5, David E Albert6, Gari D Clifford7
1Alivecor Inc., 189 N. Bernardo Ave, Suite 100, Mountain View, CA 94043, USA; Department of Biomedical Informatics, Emory University School of Medicine , 101 Woodruff Circle, Atlanta, GA 30322, USA. Electronic address: alireza.rafiei@emory.edu.
2Alivecor Inc., 189 N. Bernardo Ave, Suite 100, Mountain View, CA 94043, USA. Electronic address: tdwivedi717@alivecor.com.
3Alivecor Inc., 189 N. Bernardo Ave, Suite 100, Mountain View, CA 94043, USA. Electronic address: jxue656@alivecor.com.
4Alivecor Inc., 189 N. Bernardo Ave, Suite 100, Mountain View, CA 94043, USA. Electronic address: dschlesinger808@alivecor.com.
5Department of Biomedical Informatics, Emory University School of Medicine , 101 Woodruff Circle, Atlanta, GA 30322, USA. Electronic address: nkatebi@emory.edu.
6Alivecor Inc., 189 N. Bernardo Ave, Suite 100, Mountain View, CA 94043, USA. Electronic address: drdave@alivecor.com.
7Department of Biomedical Informatics, Emory University School of Medicine , 101 Woodruff Circle, Atlanta, GA 30322, USA; Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive, Atlanta, GA, USA. Electronic address: gari@gatech.edu.
PubMed DOI

Abstract

BACKGROUND: Electrode positioning directly influences the interpretation and diagnostic quality of ECG recordings. While current solutions mainly focus on detecting lead swaps in standard full-lead configurations, the growing adoption of portable and reduced-lead devices underscores the need for effective methods to identify and quantify electrode misplacement in various settings. METHODS: We dev…

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