van der Schaaf Iris, Kloosterman Manon, Chandrasekaran Deepthi Priya, Loh Peter, de Bie Johan, van Dam Peter M
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", Bologna, Italy.
Heart Rhythm O2. 2025 Jan 31;6(4):450-462. doi: 10.1016/j.hroo.2025.01.016. eCollection 2025 Apr.
Body surface potential mapping (BSPM) can provide a detailed assessment of cardiac electrical activity and might be of potential added benefit in multiple cardiac diseases. Normal intra- and interpersonal variation in BSPM is not clearly described and could be of use in the distinction between normal variation and cardiac disease development.
The purpose of this study was to describe the effects of normal respiration, changes in body position, repeated electrode placement, and heart rate differences on BSPM signals in a healthy population.
Sixty-seven-lead BSPM was performed in healthy individuals during the resting supine position, a reclined position of 45°, an exercise-increased heart rate, and a follow-up measurement in the resting supine position after 1 week to determine the effect of repeated electrode placement. R-, S- and T-wave amplitudes in all leads were compared between the baseline supine position and the aforementioned conditions.
Ten subjects were included {5 (50%) male; median age 28 years (interquartile range [IQR] 26-30 years)}. The R-wave showed the greatest amplitude variation across all conditions, with the largest changes caused by repeated electrode placement (maximum decrease -0.63 mV [IQR -0.69 to -0.22 mV]) and normal respiration (maximum increase 0.32 mV [IQR 0.08-0.55 mV]) and the smallest changes due to reclined position (maximum decrease -0.23 mV [IQR -0.28 to -0.15 mV]). Electrodes near standard precordial positions were most affected. The exercise-increased heart rate reduced the R-wave amplitude in left-sided electrodes and increased the S-wave amplitude in middle superior electrodes. T-wave amplitude generally increased after exercise.
Normal intrapersonal variation in BSPM signals was analyzed. Repeated electrode placement and normal respiration caused the largest amplitude changes. These findings may help differentiate normal variation from pathological changes in BSPM.
体表电位标测（BSPM）可对心脏电活动进行详细评估，可能对多种心脏疾病具有潜在的附加益处。BSPM正常的个体内和个体间差异尚未得到清晰描述，可能有助于区分正常变异与心脏疾病发展。
本研究旨在描述正常呼吸、体位变化、重复电极放置和心率差异对健康人群BSPM信号的影响。
对健康个体进行67导联BSPM检查，包括静息仰卧位、45°斜卧位、运动增加心率时，以及1周后静息仰卧位的随访测量，以确定重复电极放置的影响。比较所有导联在基线仰卧位与上述条件下的R波、S波和T波振幅。
纳入10名受试者{5名（50%）男性；年龄中位数28岁（四分位间距[IQR]26 - 30岁）}。R波在所有条件下显示出最大的振幅变化，最大变化由重复电极放置（最大降低-0.63 mV[IQR -0.69至-0.22 mV]）和正常呼吸（最大增加0.32 mV[IQR 0.08 - 0.55 mV]）引起，而由斜卧位引起的变化最小（最大降低-0.23 mV[IQR -0.28至-0.15 mV]）。标准心前区位置附近的电极受影响最大。运动增加心率使左侧电极的R波振幅降低，使中上侧电极的S波振幅增加。运动后T波振幅通常增加。
分析了BSPM信号正常的个体内变异。重复电极放置和正常呼吸引起的振幅变化最大。这些发现可能有助于区分BSPM中的正常变异与病理变化。
