number and absolute value of maxima and minima were assessed for every map. Results: Only bipolar maps (bp) were recorded in the healthy control group; mp were found in 55% (12) of the heart failure patients (mp with multiple minima, multiple maxima, or both multiple minima and maxima). All patients with mp IQRST had also mp IPST, 67% mp IPQRS, 33% mp IQ40, 17% mp IQRS, 67% mp ISTT, and 50% mp IST maps. Significant differences were noticed in maxima and minima in heart failure patients compared with healthy controls (IQ40 maxima: 14 ± 9 mV.ms in heart failure patients vs 16 ± 3.8 mV.ms in healthy controls, P = .014). We found significant different IPST minima and IST maxima in heart failure patients with mp IQRST maps compared with those with bp IQRST maps. IQRST maxima (119 ± 48 mV.ms vs 68 ± 17 mV.ms, P = .0026) and minima (−72 ± 28 mV.ms vs −40 ± 10 mV.ms, P = .0057) were also significantly different in patients with mp IQRST maps compared with those with bp IQRST maps. IQ40 maxima (7.5 ± 3.4 mV.ms vs 17 ± 7.8 mV.ms, P = .00054) and minima (−5 ± 2.44 vs −19 ± 11.7 mV.ms, P = .006) and IQRS minima (−26 ± 11 mV.ms vs −47 ± 28 mV.ms, P = .038) were significantly different in heart failure patients with mp IQ40 vs IQRS maps compared with those with bp maps. Ventricular arrhythmia appeared in 18% (4) of the heart failure patients. Patients with mp IST maps were more likely to die suddenly than patients with mp IQRST maps (odds ratio [OR], 2.5; 95% confidence interval [CI], 0.125-49.86), mp IPST maps (OR, 3; 95 %CI, 0.153-58.74), and mp IPQRS maps (OR, 2; 95% CI, 0.097-41). Conclusion: Postinfarction heart failure is associated with an increased prevalence of multipolar maps and causes significant changes of maxima and minima. Multipolar isointegral ST maps are better predictors of sudden cardiac death compared with multipolar IQRST, IPST, or IPQRS maps.