Detection and localization of coronary artery disease with body surface mapping in patients with normal electrocardiograms.

Abstract

Patients with clinically significant coronary artery disease often have normal resting electrocardiograms. Clinical and experimental studies have shown that body surface potential maps provide improved recognition of some disease states and more regionally selective information than standard electrocardiograms. Body surface maps were recorded at rest from 41 symptomatic patients with angiographically documented coronary artery disease and normal electrocardiograms. Patient maps were statistically compared with maps recorded from 644 normal subjects with the use of previously reported data representation technique. By this technique, maps from patients with symptomatic coronary artery disease and normal electrocardiograms were separated from maps of normal subjects with a sensitivity and specificity greater than 94%. The majority of discriminating information was present in the QRS interval. Fifteen of the 41 symptomatic patients had documented single-vessel coronary disease and their maps were separately compared with normal maps. Average maps from each of three patient groups with single-vessel disease contained abnormal patterns during the QRS interval that were unique to the vessel affected. In comparison with a average map from normal subjects, the average map from the group with left anterior descending coronary disease showed lower potentials over the anterior and inferolateral thorax during the early to mid QRS interval, the average map from the circumflex disease group showed decreased potentials around the entire inferior thorax in the mid to late QRS interval, and the average map from the right coronary disease group showed decreased potentials over the right anterior thorax during the mid to late QRS interval.(ABSTRACT TRUNCATED AT 250 WORDS)