Implications of an early reversal pattern of body surface potential maps in coronary artery disease

During early ventricular depolarization, the normal body surface potential map (BSPM) has a maximal potential that is greater than the absolute value of the minimal potential; this reverses in late depolarization, so that the absolute value of the minimal potential is greater. Nevertheless, an abnor mal "early reversal" BSPM pattern has been observed in some patients with c ardiovascular disease. To investigate the implications of this abnormal pat tern, BSPMs were studied in 100 patients with angiographically proven coron ary artery disease (CAD). There were 57 patients (57%; group A) with an abn ormal early reversal pattern and 43 (43%; group B) without this early rever sal pattern. A significant (> 70% narrowing) CAD lesion was observed in a s ignificantly higher proportion of group A (97%) than group B (77%) patients , although the number of involved coronary arteries was not significantly d ifferent between the two groups. The maximal extent of the abnormal negativ e potential was significantly greater in group A (21.2 +/- 9.6 cm(2)) than in group B (12.2 +/- 7.5 cm(2)). The abnormal negative potential lasted sig nificantly longer in group A (22.1 +/- 12.1 msec) than in group B (14.4 +/- 9.2 msec). Similarly, the minimal potential lasted significantly longer in group A (20.1 +/- 11.3 msec) than in group B (11.8 +/- 7.1 msec). These fi ndings suggest that the abnormal early reversal BSPM pattern is a valuable indicator of extensive myocardial lesions and the severity of CAD.