Prediction of accessory pathway locations in Wolff-Parkinson-White syndrome with body surface potential Laplacian maps - A simulation study

An electrocardiographic computer simulation was conducted to study the feas ibility of predicting accessory pathway locations in Wolff-Parkinson-White (WPW) syndrome with body surface potential Laplacian maps. Three-dimensiona l, realistically-shaped heart and torso models were used. Ten accessory pat hways (APs) around the atrioventricular ring corresponding to Gallagher et al. were set in the heart model, and body surface Lapacian and potential ma ps of WPW syndrome with single or multiple APs were simulated and compared to each other. In simulations with a Single AP in the anterior walls, the m aximum-minimum pairs in Laplacian maps appeared to be similar to those in p otential maps with respect to their locations and orientations, but the max imum-minimum pairs in Laplacian maps were sharper and more localized than i n potential maps. In simulations with a posterior AP or multiple APs, the m aximum-minimum pairs in the Laplacian maps showed features correlative to t he,AP locations, but no such features were found in potential maps. These r esults suggest the possibility of using Laplacian maps, as a non-invasive m ethod for predicting accessory pathways locations in WPW syndrome.