High-Resolution Body Surface Potential Mapping in Exercise Assessment of Ischemic Heart Disease

Abstract

Standard 12-lead ECG exercise testing is commonly used for screening of ischemic heart disease (IHD). We studied if high-resolution body surface potential mapping (HR-BSPM) during exercise offers advantages over current standards in noninvasive evaluation of IHD. This study was carried out on 90 IHD patients and 33 healthy controls. The 67-lead HR-BSPM was recorded at rest and during exercise. Twenty-one ECG parameters including classical ST criteria were compared. The effectiveness of methods was verified based on the results of SPECT and coronary angiography. The most effective parameters in the diagnosis of IHD were: amplitude parameter ΔST60 and δT parameter showing T-wave morphology changes during exercise. The sensitivities/specificities of ΔST60 and δT parameters for the HR-BSPM were 70/69 and 59/62%, while for the standard 12-lead ECG system they were: 63/62 and 59/56%. These results demonstrate the usefulness of HR-BSPM measurements during exercise. HR-BSPM resulted in higher sensitivities and specificities compared to the standard 12-lead exercise test. The advantage was partially associated with observed ischemic changes outside standard precordial leads position that were not visible when using the standard 12-lead exercise test. This justifies research into the optimization of the number and position of ECG leads in exercise testing.

Body Surface Potential Mapping: Contemporary Applications and Future Perspectives

“…Specifically, they observed over 20% increase in sensitivity when using BSPM compared to standard 12-lead ECGs. Other groups have replicated these results [151,152]. The reason for the improved sensitivity and specificity is associated with an improved overall coverage of body surface potentials, allowing for capture and examination of ST-segment changes that may not appear initially within the region observed by 12-lead ECGs [152].…”

“…The reason for the improved sensitivity and specificity is associated with an improved overall coverage of body surface potentials, allowing for capture and examination of ST-segment changes that may not appear initially within the region observed by 12-lead ECGs [152]. Others have validated these results across multiple patient groups, and with gold-standard SPECT imaging [152].…”