QRS onset and offset detection accuracy improvement by additional spatial information in body surface potential maps

A new automatic spatiotemporal algorithm has been developed for detecting QRS onset and offset in body surface potential mapping. The new algorithm, based on a spatial and temporal approach, along with three other algorithms (total energy, 3-lead, and median), was tested in 73 normal and abnormal patients. The reference or gold standard onset and offset times were determined visually by two experienced investigators. The results demonstrate that the new method is less sensitive to noise, to the temporal overlap of the QRS and other components, and to the spatial location changes of QRS initial and final activation. The spatiotemporal method resulted in very consistent findings, with a standard deviation of less than one third of the standard deviation in the next best method.