Characteristic findings of body surface potential map during ventricular repolarization in patients with coronary heart disease

The objective of the present study was to investigate the characteristics o f body surface potential map (BSPM) findings during ventricular repolarizat ion in patients with coronary artery disease (CAD). A total of 108 consecutive patients, 99 men and 9 women with angina pectori s and positive treadmill exercise test results as well as angiographically documented CAD underwent BSPM study in a fasting state. Their ages ranged f rom 30 to 70 years. There were 13 patients with right coronary artery (RCA) lesions, 37 with left anterior descending artery (LAD) lesions, 5 with lef t circumflex artery (LCX) lesions, 17 with both RCA and LAD lesions, 12 wit h both LCX and LAD lesions, and 24 with S-vessel disease. The BSPMs were ob tained by using the heart potential map system designed by Toyama et al. Th ere were 59 lead points on the anterior chest wall and 28 on the back. The BSPMs in isopotential distribution were made every one msec throughout the ventricular activation period. The distribution of positive and negative po tentials, potential maximum and potential minimum, polarity of potential di stribution, and the reversal of potential distribution during ventricular r epolarization were analyzed. The following information on BSPMs was obtained: (1) In early ventricular r epolarization, the negative potential and the potential minimum appeared ab normally on the anterior thorax. The potential abnormality displayed on the right portion or the inferior portion in patients with RCA lesions, on the middle portion or the left portion in patients with LAD lesions, and on th e left-superior portion or the left-middle portion in patients with LCX les ions. In patients with multi-vessel disease, the abnormal potential distrib ution showed a combined pattern of individual vessel lesions. (2) In some c ases, the multipolar potential distribution appeared abnormally during the initial stage and the peak of the T wave. (3) The reversal of potential dis tribution was observed in about half of the patients. The characteristic findings of the BSPM during ventricular repolarization, including abnormal potential distribution, multipolar potential distributio n and reversal of potential distribution, will be of clinical value in pati ents with CAD.