Abstract
Introduction: Late potentials (LP) are markers of arrhythmogenic events after myocardial infarction (MI). The localization of LP sources would help to identify arrhythmogenic myocardium. The purpose of this study was to localize these LP sources from non-invasive body surface mapping data. Methods and Results: Six patients were investigated with cardiac MRI and signal averaged 62-lead magnetocardiography after MI. Three of them were suffering from sustained ventricular tachycardia (VT). Sophisticated computer algorithms were used in order to compute the current density on the surface of the left ventricle. We compared these current density distributions for the entire QRS complex and the high frequency LP signals. In the three patients which had premature ventricular complexes (PVCs) we localized the exit sites of these arrhythmias. We found a close matching of the low current density areas based on the QRS complexes and the high current density areas based on the LP signals. These areas predominantly corresponded to sites of the infarctions. Exit sites of PVCs were located close to these areas. Conclusions: By means of sophisticated computer algorithms we were able to localize LP sources. This would be useful in steering catheter ablation and coronary revascularization therapies. However, the method has to be proven with the help of invasive mapping in a larger number of patients.
Similar content being viewed by others
References
Han J. Mechanisms of ventricular arrhythmias associated with myocardial infarction. Am J Cardiol 1969; 24(6): 800-813.
Berbari EJ, Scherlag BJ, Hope R, Lazzara R. Recordings from the body surface of arrhythmogenic ventricular activity during ST segment. Am J Cardiol 1978; 41(4): 697-702.
Simson MB. Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction. Circulation 1981; 64(2): 235-242.
Breithardt G, Cain ME, El-Sherif N, et al. Standards for analysis of ventricular late potentials using high resolution or signal averaged electrocardiography. A statement by a Task Force Committee of the European Society of Cardiology, The American Heart Association and The American College of Cardiology. Circulation 1991; 83(4): 1481-1488.
Sasaki Y, Furihata A, Suyama K. Correlation of the endocardial fragmented electrogram with body surface signal-averaged electrocardiographic mapping. Pacing Clin Electrophysiol 1994; 17(9): 1477-1486.
Savard P, Faugere G, Nadeau RA, et al. The spatial distribution of late ventricular potentials. J Electrocardiol 1987; 20: 114-118.
Leder U, Haueisen J, Huck M, Nowak H. Non-invasive imaging of arrhythmogenic left-ventricular myocardium after infarction. Lancet 1998; 352(9143): 1825.
Dossel O, David B, Fuchs M, Kruger J, Kullmann WH, Ludeke KM. A modular approach to multichannel magnetometry. Clin Phys Physiol Meas 1991; 12(suppl B): 75-79.
Fuchs M, Wischmann HA, Wagner M, Kruger. J. Coordinate system matching for neuromagnetic and morphological reconstruction overlay. IEEE Trans Biomed Eng 1995; 42(4): 416-420.
Schwan HP, Kay CF. The conductivity of living tissues. Ann NY Acad Sci 1957; 65: 1997-2013.
Fuchs M, Wagner M, Köhler T, Wischmann HA. Linear and nonlinear current density reconstructions. J Clin Neurophysiol 1999; 16(3): 267-295.
Green LS, Lux RL, Haws CW. Detection and localization of coronary artery disease with body surface mapping in patients with normal electrocardiograms. Circulation 1987; 76(6): 1290-1297.
Freedman RA, Fuller MS, Greenberg GM, et al. Detection and localization of prolonged epicardial electrograms with 64-lead body surface signal-averaged electrocardiography. Circulation 1991; 84(2): 871-883.
Savard P, Ackaoui A, Gulrajani RM, et al. Localization of cardiac ectopic activity in man by a single moving dipole. Comparison of different computation techniques. J Electrocardiol 1985; 18(3): 211-221.
Nomura M, Nakaya Y, Saito K, et al. Noninvasive localization of accessory pathways by magnetocardiographic imaging. Clin Cardiol 1994; 17(5): 239-244.
Nenonen J, Makijarvi M, Toivonen L, et al. Non-invasive magnetocardiographic localization of ventricular pre-excitation in the Wolff-Parkinson-White syndrome using a realistic torso model. Eur Heart J 1993; 14(2): 168-174.
Fenici R, Melillo G. Magnetocardiography: ventricular arrhythmias. Eur Heart J 1993; 14(suppl E): 53-60.
Weismuller P, Abraham Fuchs K, Killmann R, et al. Magnetocardiography: three-dimensional localization of the origin of ventricular late fields in the signal averaged magnetocardiogram in patients with ventricular late potentials. Eur Heart J 1993; 14(suppl E): 61-68.
Haueisen J, Bottner A, Funke M, Brauer H, Nowak H. Effect of boundary element discretization on forward calculation and the inverse problem in electroencephalography and magnetoencephalography. Biomed Tech 1992; 42(9): 240-248.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Leder, U., Haueisen, J., Pohl, P. et al. Localization of late potential sources in myocardial infarction. Int J Cardiovasc Imaging 17, 315–325 (2001). https://doi.org/10.1023/A:1011623103742
Issue Date:
DOI: https://doi.org/10.1023/A:1011623103742