ST-segment changes in high-resolution body surface potential maps measured during exercise to assess myocardial ischemia: a pilot study

Kania, Michał; Zaczek, Rajmund; Zavala-Fernandez, H.; Janusek, Dariusz; Kobylecka, Małgorzata; Królicki, Leszek; Opolski, Grzegorz; Maniewski, Roman

doi:10.5114/aoms.2013.39938

Cited by 4 publications

(4 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This suggests that HR-BSPM may reveal hidden information important in reliable IHD diagnostics. This is in accordance with our preliminary findings in which ischemic changes in the ECG signal were observed in non-standard electrode locations, often in the absence of changes in standard ECG leads 13,15–17,34…”

Section: Introductionsupporting

confidence: 93%

See 1 more Smart Citation

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

et al. 2019

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionsupporting

confidence: 93%

“…This is in accordance with our preliminary findings in which ischemic changes in the ECG signal were observed in non-standard electrode locations, often in the absence of changes in standard ECG leads. 13 , 15 – 17 , 34 …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…3 of Ref. 17 [1517]. It is suggested that the ventricular repolarization wave moved toward the back, in the duration from ST to T. It was possibly due to the anatomical facts that the ventricular apex was slanted toward the front and the base toward the back, and that the APD of the apex was shorter than that of the base.…”

Section: Discussionmentioning

confidence: 99%

In silico evaluation of the acute occlusion effect of coronary artery on cardiac electrophysiology and the body surface potential map

Ryu

Lee

Kwon

et al. 2019

Korean J Physiol Pharmacol

View full text Add to dashboard Cite

Body surface potential map, an electric potential distribution on the body torso surface, enables us to infer the electrical activities of the heart. Therefore, observing electric potential projected to the torso surface can be highly useful for diagnosing heart diseases such as coronary occlusion. The BSPM for the heart of a patient show a higher level of sensitivity than 12-lead ECG. Relevant research has been mostly based on clinical statistics obtained from patients, and, therefore, a simulation for a variety of pathological phenomena of the heart is required. In this study, by using computer simulation, a body surface potential map was implemented according to various occlusion locations (distal, mid, proximal occlusion) in the left anterior descending coronary artery. Electrophysiological characteristics of the body surface during the ST segment period were observed and analyzed based on an ST isointegral map. We developed an integrated system that takes into account the cellular to organ levels, and performed simulation regarding the electrophysiological phenomena of the heart that occur during the first 5 minutes (stage 1) and 10 minutes (stage 2) after commencement of coronary occlusion. Subsequently, we calculated the bipolar angle and amplitude of the ST isointegral map, and observed the correlation between the relevant characteristics and the location of coronary occlusion. In the result, in the ventricle model during the stage 1, a wider area of ischemia led to counterclockwise rotation of the bipolar angle; and, during the stage 2, the amplitude increased when the ischemia area exceeded a certain size.

show abstract

“…The analysis of the maps of T-wave alternans coefficient values showed strong differentiation in the level of the received TWA signals on the location of the receiving electrode on the thorax. In some of the examined patients the T-wave alternans would not have been detected using the traditional standard twelve-lead system, as a diagnostically important signal level was recorded in the leads outside the standard layout [ 20 – 22 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of T-wave alternans in high-resolution ECG maps recorded during the stress test in patients after myocardial infarction

Janusek

Kania

Zaczek

et al. 2015

aoms

Self Cite

View full text Add to dashboard Cite

IntroductionRecent studies point to analysis of T-wave alternans as a promising indicator of an increased risk of life-threatening ventricular arrhythmias. In this study the occurrence of T-wave alternans in the high-resolution ECGs recorded during the exercise stress test and scintigraphic tests (SPECT) in patients with ischemic heart disease was examined.Material and methodsThe study group consisted of 33 patients after myocardial infarction. In the group of patients after myocardial infarction and with low left ventricular ejection fraction correlations of 70% between the test results of T-wave alternans and SPECT and 60% between the test results of T-wave alternans and stress test were found.ResultsIn the group of patients after myocardial infarction but with high left ventricular ejection fraction correlations were respectively 39% and 48%. The analysis of the electrocardiographic maps showed a strong dependence of this correlation on the T-wave alternans amplitude and location of the ECG measuring electrode on the chest. The results might suggest that in patients after myocardial infarction and at increased risk for sudden cardiac death T-wave alternans may also provide information about cardiac electrical instability associated with ischemia.ConclusionsIt can also be assumed that the position of the electrode where the highest level of the T-wave alternans was detected can indicate the location of the ischemic region of the heart.

show abstract

ST-segment changes in high-resolution body surface potential maps measured during exercise to assess myocardial ischemia: a pilot study

Cited by 4 publications

References 31 publications

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

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

In silico evaluation of the acute occlusion effect of coronary artery on cardiac electrophysiology and the body surface potential map

Evaluation of T-wave alternans in high-resolution ECG maps recorded during the stress test in patients after myocardial infarction

Contact Info

Product

Resources

About