Posterior Body Surface Potential Mapping Using Capacitive-Coupled Electrodes and Its Application

Abstract

Using 49 capacitive-coupled electrodes, mattress-type harness was developed to obtain posterior body surface potential map (P-BSPM) in dressed individuals. The aim of this study was to investigate how valuable information P-BSPM could provide, especially in discrimination of old myocardial infarction (OMI). P-BSPM of 59 individuals were analyzed; 23 normal control, 11 right bundle branch block (RBBB), 3 left bundle branch block (LBBB) and 19 OMI patients. Principal component analysis and linear hyper-plane approach were used to evaluate diagnostic performance. The axes of P-BSPM vector potential corresponded well with 12-lead electrocardiogram. During QRS, the end point of P-BSPM vector potential demonstrated characteristic clockwise rotation in RBBB, and counterclockwise rotation in LBBB patients. In OMI, initial negativity on P-BSPM during QRS was more frequently located at lower half, and also stronger in patients with inferior myocardial infarction (MI). The area under the receiver-operating characteristic curve of P-BSPM during QRS in diagnosing overall OMI, anterior MI, and inferior MI was 0.83 (95% confidence interval, 0.70-0.97), 0.71 (0.47-0.94), and 0.98 (0.94-1.0), respectively (P = 0.022 for anterior vs inferior MI groups). In conclusion, the novel P-BSPM provides detailed information for cardiac electrical dynamics and is applicable to diagnosing OMI, especially inferior myocardial infarction.