BODY-SURFACE LAPLACIAN MAPPING IN PATIENTS WITH LEFT OR RIGHT-VENTRICULAR BUNDLE-BRANCH BLOCK

Body surface Laplacian maps (BSLMs) have been previously reported to p rovide enhanced capability in localizing and resolving multiple spatia lly separate myocardial events. However, Only a few studies have been reported on the clinical applications of BSLM. To test the clinical ut ility of BSLMs, BSLMs and body surface potential maps (BSPMs) during v entricular depolarization for complete right or left ventricular bundl e branch block (CRBBB or CLBBB) were studied in ten patients in each g roup. As a control group, ten healthy subjects were also studied using the same procedure. One hundred and twenty-eight electrodes were plac ed uniformly over the entire chest and back of the subjects. BSLMs wer e computed from recorded potentials, using a numerical algorithm. The BSLMs showed multiple and more localized positive and negative activit ies compared with the BSPMs. in healthy subjects, the BSLMs showed mul tiple areas of positive activity overlying the RV, LV, and the RV outf low and negative activity corresponding to RV free-wall breakthrough a nd LV anterolateral breakthrough sites, whereas the BSPMs could not se parate RV and LV activities. In the patients with CRBBB, the BSLMs sho wed more localized areas of activity corresponding to the LV apex brea kthrough and LV lateral breakthrough, and separated LV lateral and pos terior activation. In the patients with CLBBB, the BSLMs showed multip le RV activation, and propagating activation of LV from lateral to pos terior. The BSLMs appear to provide enhanced capability in detecting m ultiple Ventricular electrical events associated with normal and abnor mal conduction and a more detailed activation sequence of both ventric les in healthy subjects and in the patients with CRBBB and CLBBB. BSLM may provide an important alternative to other imaging modalities in l ocalizing cardiac electrical activity noninvasively.