Relation between spatial distribution of late potentials and location of origin of premature ventricular complexes on body surface map in patients with postinfarction ventricular tachycardia
2000
Abstract We studied the relationship between the spatial distribution of late potentials (LPs) and the origin of premature ventricular complexes (PVCs) using body surface maps in 55 patients with postinfarction sustained ventricular tachycardia (VT). Body surface maps were recorded from 87 leads to construct departure maps during sinus rhythm and signal-averaged ECGs were recorded from 32 unipolar leads to construct a LP map. The root-mean-square values during 40 ms intervals behind the QRS end were computed as LPs. The PVC map was recorded simultaneously in 14 patients presenting PVC with similar morphology to VT during LP detection. The origin of PVC was localized at the site of isopotential minimum when the potential exceeded −0.5 mV during the early QRS period. The LP area and the departure area showed a similar distribution. However, the PVC origin was closer to the site of LP maximum than the departure minimum in 11 (79%) patients, and the spatial correlation between the LP maximum and the PVC origin was good in 12 (86%) patients. LP and PVC mapping from the body surface is feasible and of worth to predict noninvasively the site of origin of ventricular arrhythmias in patients with remote myocardial infarction and sustained VT.
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