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Results for “Body Surface Potential Mapping”

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At least 127 records · Page 7Linked to original sources

PubMed1986

Body surface potential mapping in ischemic patients with normal resting ECG.

Patients with ischemic heart disease frequently have a normal 12-lead electrocardiogram. We recorded body surface maps from 14 ischemic patients with normal (group A) and 5 with abnormal (group B) resting electrocardiograms. ST-T map data were compared with those of 36 normal subjects. In ischemic patients the following abnormalities were found: an anomalous location and/or trajectory of the potential minimum (lowest potential) on the chest in some; in others the instantaneous values of the time functions: Mxi (highest potential on the chest), delta Vi (highest potential difference) and integral of s/Vi/dS (integral of the absolute value of the potential function extended to the entire chest surface) were lower. In some ischemic patients, both abnormalities were observed. All changes were detectable during the first 200 msec of ST-T. The anomalous potential patterns were similar in group A and B patients, suggesting an ischemic origin of group A abnormalities. By submitting 10 properly selected variables, obtained from body surface maps, to Fisher's discriminant analysis, we succeeded in correctly classifying more than 90% of the cases. The efficacy of the method was validated by using one third of the cases as a test set, with correct allocation in 80.9% of the cases. We conclude that body surface maps at rest can reveal an altered cardiac electrogenesis induced by myocardial ischemia, not apparent in the 12-lead electrocardiogram.

Action Potentials↗

PubMed1995

Spatial features in body-surface potential maps can identify patients with a history of sustained ventricular tachycardia.

BACKGROUND: Regional disparities of ventricular primary-repolarization properties contribute to an electrophysiological substrate for arrhythmias. Such disparities can be assessed from body-surface distributions of ECG QRST areas. Our objective was to isolate and test those features of QRST-area distributions that would be suitable for identifying patients at risk for life-threatening ventricular arrhythmias. METHODS AND RESULTS: We recorded ECGs simultaneously from 120 leads during sinus rhythm for 204 patients taking no antiarrhythmic drugs: half had had sustained ventricular tachycardia (VT); the other half, a myocardial infarction but no history of VT. For each patient, we calculated the QRST area in each lead and, using Karhunen-Loeve (K-L) expansion, reduced these data to 16 coefficients (each relating to one spatial feature, an eigenvector, derived from the total set of 204 QRST-area maps). Using stepwise discriminant analysis, we selected feature subsets that best discriminated between the two groups, and we estimated by a bootstrap procedure using 1000 trials how these subsets would perform on a prospective patient population. The mean diagnostic performance of the classifier for 1000 randomly selected training sets (n = 102 in each, with both groups equally represented) increased monotonically with the number of features used for classification. The initial trend for the corresponding test sets (n = 102 in each) was the same but reversed when the number of features exceeded eight. For an optimal set of eight spatial features, the sensitivity and specificity of the classifier for detecting patients with VT in 1000 test sets were (mean +/- SD) 90.3 +/- 4.3% and 78.0 +/- 6.1%, and its positive and negative predictive accuracies were 80.7 +/- 4.2% and 89.2 +/- 4.2%, respectively. Use of QRS duration as a supplementary feature to eight K-L coefficients can, in the test sets, increase specificity to 80.9 +/- 5.4% and positive predictive accuracy to 82.8 +/- 3.9% compared with the results for the optimal number of eight K-L features alone. CONCLUSIONS: Multiple body-surface ECGs contain valuable spatial features that can identify the presence of an arrhythmogenic substrate in the myocardium of patients at risk for ventricular arrhythmias. Our results compare very favorably with those achieved by any other known test, invasive or noninvasive, for arrhythmogenicity.

Body Surface Potential Mapping↗

PubMed1980

The influence of electrode placement in the reconstruction and analysis of body surface potential maps from limited thoracic arrays.

Despite their capacity to indicate abnormality outside the scope of routine electrocardiography, body surface maps remain extensive, time-consuming research procedures. By contrast, a 35-electrode grid which sums precordial ST segment deviations has received wide attention as a clinical monitor of acute myocardial infarction. First, this study examined the feasibility of recovering essential data from a small electrode array to construct maps equal to those obtained from a much larger array. Such a small-array technique would offer economy, easy application, plus the comprehensiveness and clinical correlation of the large system. Second, the relationships between map, small-array and a 35-component equivalent multipolar generator were explored for a transformation system which both expands the small-array data to map displays and reduces such data to non-redundant waveforms. Comparisons were made between direct maps and those derived from two 35-electrode sets on normal subjects and patients with myocardial infarction or cardiomyopathy. Electrode placement did not conform to the conventional rectangular grid; for one, the electrodes encircled the thorax symmetrically; in the other they were statistically selected for signal information content. We found 1) symmetrical electrode placement and analytic reconstruction of maps from multipolar lead components consistently reproduced known maps well (.91 correlation, 120 microvolts error); but 2) empirical electrode placement and statistical prediction of known maps averaged .99 correlation and 20 microvolts error for the normal training population and .97 and 60 microvolts for the abnormal test sample. Worsening occurred when placement and prediction methods were mixed; however, maps reconstructed by the empirical-statistical approach reduced to a reasonable approximation of equivalent generator scalar leads.

Electrocardiography↗

PubMed1987

[Eigenvector analysis in body surface potential maps for evaluating right ventricular hypertrophy in primary pulmonary hypertension].

This study related the eigenvectors derived from the QRS complex in body surface isopotential maps of normal subjects to regional myocardial excitation, with special emphasis on the right ventricle. The subjects consisted of 120 normal healthy adults and eight patients with primary pulmonary hypertension and right ventricular hypertrophy (PPH). According to the Karhunen-Loève theory, eigenvectors were derived from the normal group and the eigenvector coefficient of each subject was obtained against time for the first three components. The cumulative proportion of the first three eigenvectors was 90.3% in normals and 80.2% in PPH. The first eigenvector had a peak of eigenvector coefficients early in the QRS and had a bottom late in the QRS. The peak of the second was in the middle of the QRS. The coefficients of the third eigenvector were low compared to the former two eigenvectors, and had no characteristic time pattern. PPH had a similar time pattern of coefficients in the first eigenvector, reduced coefficients in the second, and a definite peak in the mid-QRS in the third. The average eigenvector coefficient of the third eigenvector in PPH was significantly higher than those in normal subjects (p less than 0.01). We conclude that the third eignevector derived from normal subjects strongly reflects right ventricular excitation.

Adult↗

PubMed1994

Discriminant function analysis of body surface potential maps in acute myocardial infarction.

Using a newly developed 64-electrode portable mapping device, QRS and ST-T isointegral maps were compared in 194 control subjects and 101 patients. One hundred ninety-four control subjects (mean age, 48 years; 120 men) with no history of cardiac disease were selected randomly and mapped. One hundred one patients (mean age, 62 years; 77 men) were mapped at presentation of chest pain suggestive of first myocardial infarction (MI); all patients had classic 12-lead electrocardiographic findings--46 with anterior and 55 with inferior MI. The diagnosis was confirmed in all cases by a significant rise in serial cardiac enzymes. The mean delay between onset of chest pain to map recording was 163 minutes. Of the 101 patients, 78 were first mapped outside the hospital. Applying discriminant function analysis to the isointegral measurements made on the control subjects and on the first map of MI patients achieved a correct classification of 97% of the control subjects (189 of 194) and 72% of the anterior (33 of 46) and 76% of the inferior (42 of 55) MI groups. This preliminary study suggests that discriminant function analysis, based on isointegral maps, not only provides a method of separating control subjects from MI patients but that it can also differentiate between types of infarct. Further studies are required to improve the predictive values of discriminant function and to extend the methodology to assess both the site and size of MI.

Adult↗

PubMed1993

Body surface potential mapping (BSPM) before and after percutaneous transluminal coronary angioplasty (PTCA).

The departure index area of departure maps before and after the PTCA procedure was evaluated in 10 randomly chosen patients with clinically significant ischaemic heart disease. The body surface mapping system CARDIAG 128.1, (ZPA Prague-Cakovice) was used. The departure index was calculated using Kubota's formula. The departure indexes of the ST-T interval and departure maps of 36 ms and 80 ms intervals from the J point were followed. A decrease of the departure index area was considered as a sign of successful PTCA. A correct classification was made in 6 patients out of 9 (66%) with successfully performed PTCA. The identification of one patient with unsuccessful PTCA procedure was also correctly determined. The overall correlation between the effect of PTCA and the departure index area change was 7 out of 10 (70%). The authors consider this method to be a useful non-invasive method for identifying of successful or unsuccessful PTCA in patients with coronary artery disease.

Adult↗

PubMed1991

Individual custom-designed modelling for the finite element method to be used in the forward calculation of a body surface isopotential map.

Body surface potential maps differ considerably in their pattern even among normals, depending upon torso configuration. Thus individualized modelling of the heart-torso model is certainly desirable for a forward problem if it can be achieved without much effort. In this paper such a heart-torso model which is flexible enough to adapt to different body shapes with ease will be reported. As its basic structure, the innermost sphere represents the electromotive force of the heart, the outermost ellipsoid surface representing the torso surface and nine similar ellipsoid surfaces intervening between the two with step-wise increasing diameters were considered. We made 98 radiating penetration points for the innermost sphere as well as the 10 intervening ellipsoid surfaces. By making use of neighboring points of penetration as corners, the heart-torso model was divided into 4992 tetrahedral elements for a finite element method calculation. Once this basic structure was established, it was found to be very easy to be modified in a computer in order to make it fit to individual torso configurations quite faithfully by deforming the outermost ellipsoid. Individualized torso-heart models were built and their maps were simulated using data obtained from several healthy subjects. This paper discusses the results of two individuals, one muscular and the other slender, who exhibited considerably different body surface potential maps.

Adult↗

PubMed1987