ArticleHeart (British Cardiac Society)2003
Body surface mapping improves early diagnosis of acute myocardial infarction in patients with chest pain and left bundle branch block.
Article in Heart (British Cardiac Society), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 53 citations in OpenAlex.
- Rule-based Method for Extent and Localization of Myocardial Infarction by Extracted Features of ECG Signals using Body Surface Potential Map Data.Journal of medical signals and sensors · 2013Article
- Posterior body surface potential mapping using capacitive-coupled electrodes and its application.Journal of Korean medical science · 2012Article
- Evolving considerations in the management of patients with left bundle branch block and suspected myocardial infarction.Journal of the American College of Cardiology · 2012Article
- Electrocardiographic body surface mapping: potential tool for the detection of transient myocardial ischemia in the 21st century?Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2009Review
- Body surface mapping improves early diagnosis of acute myocardial infarction in patients with chest pain and left bundle branch block.Heart (British Cardiac Society) · 2003Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo test prospectively depolarisation and repolarisation body surface maps (BSMs) for mirror image reversal, which is less susceptible to artefact, in patients with acute ischaemic-type chest pain, and to compare these BSM criteria with previously published 12 lead ECG criteria.
methodsAn 80 lead portable BSM system was used to map patients presenting with acute ischaemic-type chest pain and a 12 lead ECG with left bundle branch block (LBBB). Acute myocardial infarction (AMI) was defined by serial cardiac enzymes. Each 12 lead ECG was assessed by the criteria of Sgarbossa et al and Hands et al for diagnosis of AMI. Depolarisation and repolarisation BSMs were assessed for loss of mirror image reversal of QRS with ST-T isointegral map patterns and a change in vector angle from QRS to ST-T outside 180+/-15 degrees -findings typically seen in LBBB with AMI.
resultsOf 56 patients with chest pain and LBBB, 18 had enzymatically confirmed AMI. Patients with loss of BSM image reversal were significantly more likely to have AMI (odds ratio 4.9, 95% confidence interval 1.5 to 16.4, p = 0.007). Loss of BSM image reversal was significantly more sensitive (67%) for AMI than either 12 lead ECG method (17%, 33%) albeit with some loss in specificity (BSM 71%, 12 lead ECG 87%, 97%). Patients with AMI compared with those without AMI had a greater mean change in vector angle outside the normal range (180+/-15 degrees ), particularly between QRS isointegral and ST60 isopotential (the potential 60 ms after the J point at each electrode site) BSMs (19 degrees v 9 degrees, p = 0.038). Loss of image reversal and QRS-ST60 vector change outside 180+/-15 degrees had 61% sensitivity and 82% specificity for AMI (odds ratio 7.0, 95% confidence interval 2.0 to 24.4, p = 0.001).
conclusionsBSM compared with the 12 lead ECG improved the early diagnosis of AMI in the presence of LBBB.
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