Assessment of spatial resolution of pace mapping when using body surface potentials
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Using computer simulations and statistical methods, the resolution of pace mapping when used in combination with body surface potentials was systematically investigated. In an anatomical model of the human ventricular myocardium, pre-excitation sequences were initiated at 69 sites positioned along the atrioventricular (AV) ring and corresponding body surface potential maps (BSPMs) were calculated at 32 leads placed on the anterior torso. For each time after the onset of pre-excitation (every 4ms to 40ms) and each root-mean-square (RMS) noise level (5, 10, 20 and 50μV), BSPMs were cross-correlated and the spatial resolution defined as the largest pacing site separation at which the differences in correlation coefficients were not statistically significant (level p≥0.05). The findings indicate that when random RMS noise of 5μV was added to the simulated BSPMs, average spatial resolution over all 69 sites was at 20ms after the onset of pre-excitation within 3.5±0.9mm. The results provide theoretical evidence that statistical analysis of BSPMs obtained during pace mapping can offer improved means for subcentimetre identification of accessory pathways located along the AV ring.
KeywordsBody surface potential mapping Spatial resolution Pace mapping Pre-excitation syndrome Computer model
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- Dubuc, M., Nadeau, R., Tremblay, G., Kus, T., Molin, F., andSavard, P. (1993): ‘Pace mapping using body surface potential maps to guide catheter ablation of accessory pathways in patients with Wolff-Parkinson-White syndrome’,Circulation,87, pp. 135–143Google Scholar
- Green, L. S., Lux, R. L., Ershler, P. R., Freedman, R. A., Marcus, F. I., andGear, K. (1994): ‘Resolution of pace mapping stimulus site separation using body surface potentials’,Circulation,90, pp. 462–468Google Scholar
- Grogin, H. R., Stanley, M. L., Eisenberg, S. J., Horáček, B. M., andLesh, M. D. (1992): ‘Body surface mapping for localization of accessory pathways in WPW syndrome’,in Murray, A., andArzbaecher, R. (Eds). ‘Computers in Cardiology’ (IEEE Computer Society Press, Los Alamitos, CA), pp. 255–258CrossRefGoogle Scholar
- Horáček, B. M. (1974): ‘Numerical model of an inhomogeneous human torso’,Adv. Cardiol.,10, pp. 51–57Google Scholar
- Lux, R. L. (1993): ‘Electrocardiographic mapping: noninvasive electrophysiological cardiac imaging’,Circulation,87, pp. 1040–1042Google Scholar
- Nenonen, J., Edens, J. A., Leon, L. J., andHoráček, B. M. (1991): ‘Computer model of propagated excitation in the anisotropic human heart. I. Implementation and algorithms’,in Murray, A., andArzbaecher, R. (Eds.) ‘Computers in cardiology’ (IEEE Computer Society Press, Los Alamitos, CA), pp. 545–548Google Scholar
- Simmers, T. A., Wittkampf, F. H. M., Hauer, R. N. W., andRobles De Medina E. O. (1994): ‘In vivo ventricular lesion growth in radiofrequency catheter ablation’,Pacing Clin. Electrophysiol.,17, pp. 525–531Google Scholar
- Singer, I. (1997): ‘Interventional electrophysiology’ (Williams and Wilkins, Baltimore)Google Scholar
- Sippensgroenewegen, A., Spekhorst, H., van Hemel, N. M., Kingma, J. H., Hauer, R. N. W., De Bakker, J. M. T., Grimbergen, C. A., Janse, M. J., andDunning, A. J. (1993): ‘Localization of the site of origin of postinfarction ventricular tachycardia by endocardial pace mapping: body surface mapping compared with the 12-lead electrocardiogram’,Circulation,88, pp. 2290–2306Google Scholar