Analysis of the electrical heart field.
There are three basic procedures used for an assessment of the electrical heart field from the body surface: standard electrocardiography, vectorcardiography, and body surface potential mapping (BSPM). BSPM has two major advantages over both other methods: 1) it allows exploring the entire chest surface, thus providing all the information on the cardiac electric field available at the body surface; 2) it is more sensitive in detecting local electrical events, such as local conduction disturbances or regional heterogeneities of ventricular recovery. Nevertheless the results obtained using BSPM procedure cannot answer all questions about real causality of detected changes of the electrical heart field. We tried therefore to use mathematical model of the electrical field in order to answer these questions. A simple and anatomical forward calculation model was used to test the hypothesis whether the altered position of the heart could explain heterogeneity of repolarization at late stages of pregnancy in humans. The hypothesis was declined. Further findings included: A. Repolarization duration (represented by QT interval) in healthy subjects are distributed regularly and predictably on the body surface carrying no information about local pathology. B. At any systemic analysis of ventricular repolarization, it is vital to consider the regions where any electrode systems record low amplitudes due to methodological, not pathological reasons. C. Anatomical (heterogeneous) model did not yield superior results over simple (homogenous) ones possibly since none reflected the specific torso geometry of individual patients.
Kittnar
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Institute of Physiology, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic. okittnar@lf1.cuni.cz
Mlcek
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D000200:Action Potentials; D018780:Body Surface Potential Mapping; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006329:Heart Conduction System / Q000502:physiology*; D006801:Humans; D008955:Models, Cardiovascular; D011247:Pregnancy; D013997:Time Factors; D014672:Vectorcardiography