Horan L G, Hand R C, Flowers N C, Johnson J C, Sridharan M R
J Electrocardiol. 1980 Oct;13(4):311-21. doi: 10.1016/s0022-0736(80)80081-1.
Despite their capacity to indicate abnormality outside the scope of routine electrocardiography, body surface maps remain extensive, time-consuming research procedures. By contrast, a 35-electrode grid which sums precordial ST segment deviations has received wide attention as a clinical monitor of acute myocardial infarction. First, this study examined the feasibility of recovering essential data from a small electrode array to construct maps equal to those obtained from a much larger array. Such a small-array technique would offer economy, easy application, plus the comprehensiveness and clinical correlation of the large system. Second, the relationships between map, small-array and a 35-component equivalent multipolar generator were explored for a transformation system which both expands the small-array data to map displays and reduces such data to non-redundant waveforms. Comparisons were made between direct maps and those derived from two 35-electrode sets on normal subjects and patients with myocardial infarction or cardiomyopathy. Electrode placement did not conform to the conventional rectangular grid; for one, the electrodes encircled the thorax symmetrically; in the other they were statistically selected for signal information content. We found 1) symmetrical electrode placement and analytic reconstruction of maps from multipolar lead components consistently reproduced known maps well (.91 correlation, 120 microvolts error); but 2) empirical electrode placement and statistical prediction of known maps averaged .99 correlation and 20 microvolts error for the normal training population and .97 and 60 microvolts for the abnormal test sample. Worsening occurred when placement and prediction methods were mixed; however, maps reconstructed by the empirical-statistical approach reduced to a reasonable approximation of equivalent generator scalar leads.
尽管体表电位标测能够显示常规心电图范围之外的异常情况，但它仍然是一种繁杂、耗时的研究方法。相比之下，一种用于汇总胸前导联ST段偏移的35电极网格作为急性心肌梗死的临床监测手段受到了广泛关注。首先，本研究检验了从小电极阵列恢复关键数据以构建与大得多的电极阵列所获图形相同的图形的可行性。这样一种小阵列技术将具有经济性、易于应用的特点，同时具备大系统的全面性和临床相关性。其次，针对一种既能将小阵列数据扩展为图形显示又能将这些数据简化为非冗余波形的变换系统，探讨了图形、小阵列与一个35分量等效多极发生器之间的关系。对正常受试者以及心肌梗死或心肌病患者的直接图形与从两组35电极获得的图形进行了比较。电极放置不符合传统的矩形网格；其中一组电极对称环绕胸部；另一组电极则根据信号信息含量进行统计学选择。我们发现：1）对称电极放置以及从多极导联分量解析重建图形能够很好地重现已知图形（相关性为0.91，误差为120微伏）；但是2）对于正常训练人群，经验性电极放置以及已知图形的统计预测平均相关性为0.99，误差为20微伏，对于异常测试样本，相关性为0.97，误差为60微伏。当放置和预测方法混合使用时情况变差；然而，通过经验 - 统计方法重建的图形简化为等效发生器标量导联的合理近似。
