Spatial features in body surface potential maps of patients with ventricular tachyarrhythmias with or without coronary artery disease

Body surface potential maps (BSPM) from patients with coronary artery disea se or no structural heart disease were analyzed with respect to their spati al features and QT/QT(c) dispersion in order to determine whether BSPM allo ws identification of patients with ventricular fibrillation. QRST integral maps and QT/QT(c) dispersion were acquired from simultaneous recordings of 62 ECG leads during sinus rhythm in patients with idiopathic ventricular fi brillation (n=13), ventricular fibrillation and coronary artery disease (n= 22), coronary artery disease without ventricular fibrillation (n=21) and he althy controls (n=18). The Karhunen-Loeve transformation was applied to red uce the dimensionality of the data matrix of the QRST map to eight coeffici ents. Linear discriminant analysis allowed discrimination between idiopathi c ventricular fibrillation patients and controls with high sensitivity (85% ) and specificity (89%). However, discrimination between coronary artery di sease patients with or without ventricular fibrillation was poor (68% and 6 7%, respectively). QT, dispersion calculated from BSPM was longer in idiopa thic ventricular fibrillation patients than in controls (99+/-30 ms vs 70+/ -14 ms, P=0.009) in contrast to QT, dispersion taken from 12-lead ECG (53+/ -21 ms vs. 47+/-12 ms, P=n.s.). No significant difference was noted for cor onary artery disease patients with or without ventricular fibrillation. In conclusion, repolarization disturbances detected by BSPM allow identificati on of ventricular fibrillation patients without structural heart disease. H owever, our results do not suggest a major impact of QT/QT(c) dispersion or QRST integral mapping for identification of ventricular fibrillation patie nts with coronary artery disease. (C) 1999 Elsevier Science Ireland Ltd, Al l rights reserved.