Importance of body surface potential field representation fidelity: analysis of beat-to-beat repolarization measurements
1Department of Information Systems, University of Pannonia, Veszprém, Department of Bioengineering, Research Institute for Technical Physics and Materials Science of the Hungarian Academy of Sciences, Budapest, Hungary
Anatol J Cardiol 2007; 7(): 5-7 PubMed ID: 17584667
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Abstract

Objective: According to previous studies, the complex substrate of malignant arrhythmias needs a detailed spatio-temporal noninvasive characterization of low-amplitude dynamic changes in beat-to-beat cardiac repolarization. Methods: Body surface potential map (BSPM) records were taken on 14 healthy male and female subjects (age 20-80 years) and on 6 ventricular arrhythmia patients, 4 of them with implanted cardioverter defibrillators (ICD). Records were taken continuously, for 5 minutes, in resting, supine position. Beat-to-beat QRST integral maps, Karhunen-Loève coefficient time-series (KLi, i=1-12), RR and nondipolarity index (NDI) time-series were computed. Results: The first order statistical properties of the spatio-temporal variability of subsequent QRST integral maps were characterized by the box and whiskers plot of their KLi components. The SD2/M2 (KLi amplitude variance/mean signal energy) values of the QRST integral maps in the normal group ranged between 0.0057 and 0.008 (i.e. 0.075£SD/M£0.089). In ICD patients SD2/M2 values went up to 0.021-0.069 (i.e: 0.14£SD/M£0.26). Autocorrelation functions revealed that while in normal subjects only 5-20% of the total power had white noise character, the rest was bandwidth-limited noise. In ICD patients the weight of white noise component increased considerably. The higher the SD/M relative KL variability, the higher and more frequent NDI spikes were. Conclusions: Beat-to-beat dynamics of white noise components of high resolution BSPMs are able to stratify arrhythmia vulnerability. The temporal distribution of extreme NDI spike formations is random; the frequency is associated with the relative KL component noise levels.