Diagnosis of myocardial scars in patients with ischemic heart disease and left bundle branch block

Multichannel surface ECG-mapping with construction of integral QRST maps wa s suggested for detection of myocardial infarction and determination of its localization and size in patients with ischemic heart disease and left bun dle branch block or left ventricular aneurysm. Diagnostic potential of this method was studied in 22 patients (including 6 with postinfarction left ve ntricular aneurysm). Methods of investigation were electro- and echocardiog raphy, coronary angiography, left ventriculography, and surface multichanne l ECC-mapping with construction of differential isointegral QRST maps. The following parameters were used in interpretation of maps: minimal value of index of difference, fraction of the map (in %) occupied by values of index of difference below <-2; mean of those values of this index which did not exceed <-2. Diagnostic reliability of quantitative characteristics of QRST maps was found to be high. Most sensitive parameter for detection of left v entricular aneurysm was minimal value of index of difference which diagnost ic power reached 85%.