Umetani K, Okamoto Y, Mashima S, Ono K, Hosaka H, He B
Department of Electrical Engineering and Computer Science, University of Illinois at Chicago 60607, USA.
Pacing Clin Electrophysiol. 1998 Nov;21(11 Pt 1):2043-54. doi: 10.1111/j.1540-8159.1998.tb01122.x.
Body surface Laplacian maps (BSLMs) have been previously reported to provide enhanced capability in localizing and resolving multiple spatially separate myocardial events. However, only a few studies have been reported on the clinical applications of BSLM. To test the clinical utility of BSLMs, BSLMs and body surface potential maps (BSPMs) during ventricular depolarization for complete right or left ventricular bundle branch block (CRBBB or CLBBB) were studied in ten patients in each group. As a control group, ten healthy subjects were also studied using the same procedure. One hundred and twenty-eight electrodes were placed uniformly over the entire chest and back of the subjects. BSLMs were computed from recorded potentials, using a numerical algorithm. The BSLMs showed multiple and more localized positive and negative activities compared with the BSPMs. In healthy subjects, the BSLMs showed multiple areas of positive activity overlying the RV, LV, and the RV outflow, and negative activity corresponding to RV free-wall breakthrough and LV anterolateral breakthrough sites, whereas the BSPMs could not separate RV and LV activities. In the patients with CRBBB, the BSLMs showed more localized areas of activity corresponding to the LV apex breakthrough and LV lateral breakthrough, and separated LV lateral and posterior activation. In the patients with CLBBB, the BSLMs showed multiple RV activation, and propagating activation of LV from lateral to posterior. The BSLMs appear to provide enhanced capability in detecting multiple ventricular electrical events associated with normal and abnormal conduction and a more detailed activation sequence of both ventricles in healthy subjects and in the patients with CRBBB and CLBBB. BSLM may provide an important alternative to other imaging modalities in localizing cardiac electrical activity noninvasively.
体表拉普拉斯图（BSLMs）此前已有报道称其在定位和分辨多个空间上分离的心肌事件方面具有增强的能力。然而，关于BSLM临床应用的报道却很少。为了测试BSLMs的临床效用，对每组10例患者在心室去极化期间的BSLMs和体表电位图（BSPMs）进行了研究，以观察完全性右或左束支传导阻滞（CRBBB或CLBBB）情况。作为对照组，还对10名健康受试者采用相同程序进行了研究。在受试者的整个胸部和背部均匀放置128个电极。使用数值算法根据记录的电位计算出BSLMs。与BSPMs相比，BSLMs显示出多个且更局限的正负活动区域。在健康受试者中，BSLMs显示出多个位于右心室（RV）、左心室（LV）和RV流出道上方的正活动区域，以及与RV游离壁突破和LV前外侧突破部位相对应的负活动区域，而BSPMs无法区分RV和LV的活动。在CRBBB患者中，BSLMs显示出与LV心尖突破和LV外侧突破相对应的更局限的活动区域，并区分了LV外侧和后侧的激活。在CLBBB患者中，BSLMs显示出多个RV激活，以及LV从外侧到后侧的传播性激活。BSLMs似乎在检测与正常和异常传导相关的多个心室电事件以及健康受试者、CRBBB和CLBBB患者双心室更详细的激活序列方面具有增强的能力。BSLM可能为无创定位心脏电活动提供一种重要的替代其他成像方式的方法。
