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Results for “Body Surface Potential Mapping”

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At least 379 records · Page 21Linked to original sources
PubMed1995

[Location of atrial and ventricular insertions of accessory atrioventricular pathways using surface ECG mapping and its importance in catheter ablation therapy].

BACKGROUND: The modern non-pharmacological therapy of the WPW syndrome by means of catheter ablation is based on the interruption of the accessory pathway(-s) by radiofrequency current energy. Destruction of the morphologic substrate of the arrhythmia alters the activation wave spread in the heart. OBJECTIVES: It was the aim of this report to demonstrate the diagnostic potential of BSM in localizing both overt and concealed accessory pathways. Presented study analyzes the alterations of the cardioelectric field by means of body surface ECG mapping in two female patients with accessory pathways before and after their successful curative treatment by radiofrequency catheter ablation. METHODS: Five patients were analyzed prior and after RF catheter ablation by BSM, two of them were selected for this presentation. One patient with WPW syndrome suffered from frequent supraventricular tachycardia due to in one female patient with an overt accessory pathway. The other patient was for several years incessantly in permanent junctional reentry tachycardia due to a concealed accessory pathway. The examination comprised 12-lead ECG, orthogonal vectorcardiogram according to Frank, BSM using a regular 80-electrode-array system and signal-averaged ECG. RESULTS: The RF ablation was successful in both patients and their arrhythmia was abolished. By means of a detailed analysis of the ventricular activation prior RF ablation in the patient with WPW syndrome the precise site of the ventricular insertion of the accessory pathway in the left lateral free wall was predicted. Furthermore, alterations of the terminal QRS complex were observed when comparing pre- versus post-ablation maps. In the second patient the atrial insertion of the accessory pathway with retrograde and decremental conduction was successfully localized to the right septal region by means of pre-ablation BSM. CONCLUSIONS: Both ventricular and atrial activation can be in detail analyzed by means of BSM. Such analysis offers more precise information on the spatial component of the activation wave spread. This case report gives further evidence that BSM is a useful method for precise localization of both ventricular and atrial insertion sites of accessory pathways in patients with paroxysmal tachycardias due to this electrophysiologic abnormality. This information gained recently clinical impact since it can be directly used for faster arrhythmogenic substrate targeting during ablation therapy. (Fig. 5, Ref. 17.)

Adolescent↗
PubMed1998

Electrocardiographic identification of abnormal ventricular depolarization and repolarization in patients with idiopathic ventricular fibrillation.

OBJECTIVES: We sought to gain more insight into the arrhythmogenic etiology of idiopathic ventricular fibrillation (VF) by assessing ventricular depolarization and repolarization properties by means of various electrocardiographic (ECG) techniques. BACKGROUND: Idiopathic VF occurs in the absence of demonstrable structural heart disease. Abnormalities in ventricular depolarization or repolarization have been related to increased vulnerability to VF in various cardiac disorders and are possibly also present in patients with idiopathic VF. METHODS: In 17 patients with a first episode of idiopathic VF, 62-lead body surface QRST integral maps, QT dispersion on the 12-lead ECG and XYZ-lead signal-averaged ECGs were computed. RESULTS: All subjects of a healthy control group had a normal dipolar QRST integral map. In patients with idiopathic VF, either a normal dipolar map (29%,), a dipolar map with an abnormally large negative area on the right side of the thorax (24%) or a nondipolar map (47%) were recorded. Only four patients (24%) had increased QT dispersion on the 12-lead ECG and late potentials could be recorded in 6 (38%) of 16 patients. During a median follow-up duration of 56 months (range 9 to 136), a recurrent arrhythmic event occurred in 7 patients (41%), all of whom had an abnormal QRST integral map. Five of these patients had late potentials, and three showed increased QT dispersion on the 12-lead ECG. CONCLUSIONS: In patients with idiopathic VF, ventricular areas of slow conduction, regionally delayed repolarization or dispersion in repolarization can be identified. Therefore, various electrophysiologic conditions, alone or in combination, may be responsible for the occurrence of idiopathic VF. Body surface QRST integral mapping may be a promising method to identify those patients who do not show a recurrent episode of VF.

Adult↗
PubMedDate not supplied

[Non-invasive mapping of cardiac electric potential of a specific quasi-epicardium].

A procedure was proposed for non-invasive mapping of the cardiac electrical potential or a spherical quasiepicardium from its synchronous multichannel measurement on the surface of the chest, i.e. routine electrocardiodraphic mapping. Mathematical simulation was used to demonstrate that the quasiepicardial potential can be calculated with the accuracy sufficient for clinical diagnosis by applying the multipole electric field resolution method with allowance made for three lowest resolution terms. Due to the fact that the spherical quasiepicardium is more approximate to the heart and more concentric as to its center than the chest surface, the maps of the quasiepicardial potential permit recognition of some features of the pattern of a cardiac electric process, which do not manifest themselves in the distribution of the potential on the body's surface. The examples showing that the assessment of a cardiac abnormality can be made more accurate by using this method are given in the paper.

Body Surface Potential Mapping↗
PubMed2002

[Reentrant tachyarrhythmia related to anatomic scar or isthmus].

Macroreentrant tachyarrhythmia rotating around an atrioventricular valve annulus or an atriotomy scar occurs after myocardial infarction or surgical repair of congenital heart disease. A 3D electroanatomic mapping can visualize the abnormal myocardium and the anatomical barrier which construct the isthmus of the reentrant circuit of figure-8, single-loop, or double loop morphology. Catheter ablation can eliminate most of tachycardias if the critical isthmus is precisely located by anatomic and entrainment mapping during tachycardia. Detailed potential and pace mapping during sinus rhythm is also helpful in identifying the optimal ablation site or the isthmus, when activation mapping is not available because of hemodynamically unstable or nonsustained tachycardia.

Body Surface Potential Mapping↗
PubMed2003

Body surface Laplacian electrocardiogram of ventricular depolarization in normal human subjects.

INTRODUCTION: The body surface Laplacian electrocardiogram (ECG) mapping provides a noninvasive means for spatiotemporal mapping of cardiac electrical events. The aim of the present study was to explore the relationship between the Laplacian ECG and the underlying cardiac activities during ventricular depolarization in healthy human subjects. METHODS AND RESULTS: A 95-channel body surface potential ECG was recorded over the anterolateral chest from 11 healthy male subjects. The surface Laplacian (SL) ECG was estimated from the recorded potentials during QRS complex by means of a novel spline SL estimator, as well as by the conventional 5-point SL estimator for comparison purpose. A simulation study was also conducted using a realistic geometry heart-torso model in an attempt to qualitatively interpret the experimental results. For all subjects, more spatial details were observed in the SL ECG maps compared with the potential ECG maps, with spline SL more robust against noise than the 5-point SL. In total, three positive activities (denoted as P1, P2, P3) and four negative activities (denoted as N1, N2, N3, N4) in the spline SL ECG maps were observed during ventricular depolarization. Initial localized P1 and N1 activities were observed in 11 and 8 subjects, respectively. Then, the initial P1 was divided into three positive activities (P1, P2, P3) in 9 subjects. After the appearance of multiple positive activities, three negative activities (N2, N3, N4) appeared in 11, 8, and 9 subjects, respectively. Similar findings were obtained in the computer simulation study. CONCLUSION: The present study demonstrates that the SL ECG provides more spatial details than the potential ECG, and multiple simultaneously active ventricular activities could be revealed in the SL ECG maps. The results suggest that the SL ECG may provide an alternative for noninvasive mapping of cardiac electrical activity.

Adult↗
PubMed1999

Body surface potential field representation fidelity: analysis of map estimation procedures.

The first part of this study analyzed the spatial-temporal error distribution of the Lux-type limited lead system. Quantitative new evidence is reported that the 32-lead anterior subset estimates the further 160 leads with an average amplitude error less than 38.5 microV. The spatial error distribution revealed 8 sites where the error is the highest, primarily on the anterior side, independent of the clinical classification. The second part of the study examined inter-lead-system conversion strategies for interpolating the Lux-192 lead maps from the Montreal-63 data. The methodology based on the Laplacian interpolation yielded an average amplitude error of 143.7 microV and an average correlation of 0.87 for pattern fidelity. In this specific case a modified linear interpolation surpassed the Laplacian method. A presented example illustrates that even in cases when the fidelity of the signal information is heavily compromised the diagnostic information may remain less influenced.

Body Surface Potential Mapping↗
PubMed1997

A bioelectric inverse imaging technique based on surface Laplacians.

A new approach is proposed to solve bioelectric inverse problems by employing the surface Laplacian of the bioelectrical potential. A theoretical investigation was conducted to test the feasibility of epicardial inverse imaging of cardiac electrical activity. A two-sphere homogeneous volume conductor model, where the inner sphere represents the epicardium and the outer sphere the body surface, was used. Radial and tangential current dipoles were used to approximate localized wavefronts propagating from the endocardium to the epicardium, and ectopic myocardial activities. The epicardial potential distribution was reconstructed from the body surface Laplacians with the aid of the Tikhonov zero-order regularization technique, which then was compared with the results obtained from the body surface potentials using the same regularization scheme. The two inverse solutions were compared qualitatively via visual inspection of the reconstructed epicardial potential maps, and quantitatively by examining relative errors and correlation coefficients between the "true" and the reconstructed epicardial potentials. Both qualitative and quantitative results indicate that the surface Laplacians play a positive role in improving the ill-posed nature of the bioelectric inverse problem, which would enhance our capability of reconstructing important epicardial events such as extrema in the epicardial potential distribution. The present theoretical study suggests that the Laplacian-based inverse imaging technique may have important applications to epicardial inverse imaging and other bioelectric inverse imaging.

Artifacts↗