Identification of first acute Q wave and non-Q wave myocardial infarction by multivariate analysis of body surface potential maps.

Abstract

Diagnosis of acute NQMI and QMI (also in the presence of LVH) can be improved substantially by appropriate selection of ECG leads and features. Comparison of discriminant maps from groups A, B, and C does not support the concept of acute NQMI as a distinct ECG entity but rather as a group with infarcts of smaller size. However, pathophysiological and clinical differences between acute NQMI and acute QMI influence long-term risks and may define different therapeutic approaches.

Optimisation of Electrode Placement for New Ambulatory ECG Monitoring Devices

“…The BSPM data have previously been described in [13]. The BSPM-leads at the 117 recording sites were sampled with respect to Wilson's central terminal.…”

On the derivation of the spatial QRS-T angle from Mason-Likar leads I, II, V2 and V5

“…The remaining 117 leads were recorded from thoracic electrodes (81 anterior and 36 posterior recording sites). A comprehensive description of the BSPM data and the recording procedure can be found in [9,10]. A number of electrocardiographic leads that were required to conduct our research were associated with electrode locations that fell between the locations of the 117 thoracic electrodes.…”

Activation patterns in atrial fibrillation: contributions of body surface potential mapping.

“…Location and size of myocardial infarction has been determined from isointegral analysis of BSPM maps [129] as well as analysis of maps of abnormal Q waves and changes in ST elevation [6]. These findings have allowed an improvement in diagnosis of anterior and inferior AMI with discriminant analysis [73,74] and later other infarction locations [97] even when associated with additional complications such as bundle branch block (BBB) [95,94]. Diagnosis of AMI is improved by the use of BSPM with an overall sensitivity of 80 per cent compared to 57 per cent with the standard ECG [103].…”

“…Kornreich et al proposed to select optimum lead sets from BSPM recordings by determining the leads that showed the greatest statistically significant signal difference for separating data from diagnostic group pairs [73,76,74].…”

“…These discriminant maps were mostly used to discriminate between healthy subjects and myocardial infarction patients [73,74] or ventricular hypertrophy patients [76]. Discriminant indexes for each electrode site and each group comparison were obtained by further dividing each resulting difference by the composite standard deviation computed from the population under consideration.…”