Temporal analysis of the depolarization wave of healed myocardial infarction in body surface potential mapping.
BACKGROUND
We studied the ability of different time segments of the depolarization wave recorded with body surface potential mapping (BSPM) to detect and localize myocardial infarction (MI).


METHODS
BSPM was recorded in 24 patients with remote MI and in 24 healthy controls. Cine and contrast-enhanced magnetic resonance imaging (MRI) was used as a reference method. Patients were grouped according to anatomical location of their MI. The QRS complex was divided into six temporally equal segments, for which time integrals were calculated.


RESULTS
The time segments of the QRS complex showed different MI detection capability depending on MI location. For anterior infarction the second segment of the QRS complex was the best in MI detection and the optimal area was on the right inferior quadrant of the thorax (time integral average -1.5 +/- 1.8 mVms patients, 1.0 +/- 1.6 mVms controls, P = 0.002). For lateral infarction the first segment of the QRS complex performed best and the optimal area for MI detection was the left fourth intercostal area (time integral average 1.8 +/- 1.0 mVms patients, 0.7 +/- 0.5 mVms controls, P = 0.024). For inferior and posterior MI the mid-phases of the QRS complex were the best and the optimal area was the mid-inferior area of the thorax (time integral average -6.2 +/- 8.3 mVms patients, 3.3 +/- 4.3 mVms controls, P = 0.002; -9.1 +/- 6.1 mVms patients, 0.6 +/- 7.1 mVms controls, P = 0.001, respectively).


CONCLUSIONS
Time segment analysis of the depolarization wave offers potential for improving the detection and localization of healed MI.
Vesterinen
Paula
P
Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland. paula.vesterinen@kolumbus.fi
Hänninen
Helena
H
Karvonen
Milla
M
Lauerma
Kirsi
K
Holmström
Miia
M
Mäkijärvi
Markku
M
Väänänen
Heikki
H
Nenonen
Jukka
J
Katila
Toivo
T
Toivonen
Lauri
L
D000368:Aged; D000369:Aged, 80 and over; D018780:Body Surface Potential Mapping; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D012372:ROC Curve; D018709:Statistics, Nonparametric
D003287:Contrast Media