Spatial inversion of depolarization and repolarization waves in body surface potential mapping as indicator of old myocardial infarction

Abstract

To investigate the quantitative abnormalities induced by prior myocardial infarction (MI) on the whole electrical cardiac cycle, body surface potential mapping was recorded in 144 patients with prior MI and 75 healthy controls. QRS onset, offset and T-wave end were automatically determined from the averaged signal. Time integrals were calculated for the QRS wave and the STT wave. In MI patient group the average QRS and STT integrals showed strong negative correlation on the body surface (r = -0.901, p < 0.001) in contrast to the positive correlation in the control group (r = 0.285, p < 0.001). Sensitivity of an inverted QRS / STT integral relation to detect MI was 79%, as opposed to the sensitivity of the descriptive Minnesota code of 70%. Furthermore the degree of inversion correlated with left ventricular ejection fraction thus relating to the size of MI. © Springer-Verlag Berlin Heidelberg 2005.