To test the validity of an inverse transformation of body surface electrocardiographic maps, we compared the calculated epicardial potential distribution with thallium scintigraphic scans. Seventeen patients with first acute myocardial infarction had body surface electrocardiographic maps a mean of 12.1 ± 13.8 h after the onset of symptoms. Thallium scanning was performed a mean of 3.6 ±2.5 months after the myocardial infarction and before further clinical cardiac events. The thallium scans were divided into 5 regions on each of the three standard views. Each of these 15 regions was classified as infarcted or normal. The calculated epicardial potentials were calculated over a 20-ms interval centered 140 ms after the onset of the QRS complex. The mean epicardial potential related to each thallium scan area was calculated. Epicardial region potentials exceeding 20% of the normalized mean epicardial potential maximum were regarded as representing the area of myocardial infarction. The areas of thallium and electrical potential abnormality were compared. The surface potentials were correctly positive in 66 of 106 comparisons and correctly negative in 106 of 149 comparisons. Calculated epicardial potentials matched thallium scan abnormalities in 67 % of the areas. This suggests that the calculated epicardial potentials may have a role in predicting infarct size.

Keywords:
Infarction size, Body surface mapping, Myocardial damage, Inverse transformation
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1991
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