Body surface isopotential maps during the first week of life
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H Suzumiya1, Y Matsuoka, K Hayakawa
1Department of Pediatrics, Miyazaki Medical College, Japan.
Insights
Body surface potential maps reveal distinct ventricular activation and recovery patterns in newborns. These infant electrocardiogram (ECG) findings differ from those in children and evolve rapidly within the first week of life.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
- Biomedical Engineering
Background:
- Understanding normal cardiac electrical activity in newborns is crucial for diagnosing congenital heart conditions.
- Body surface potential mapping (BSPM) offers a non-invasive method to assess cardiac electrophysiology.
- Previous studies have established baseline BSPM characteristics in older children, but data in the neonatal period is less defined.
Purpose of the Study:
- To characterize ventricular activation and recovery patterns using body surface isopotential maps in normal newborns.
- To compare neonatal BSPM findings with those previously reported for normal children.
- To investigate the temporal evolution of T wave map morphology during the first week of life.
Main Methods:
- Analysis of 100 body surface isopotential maps from 30 healthy infants aged 3 hours to 7 days.
- Evaluation of QRS complex and T wave morphology and spatial distribution.
- Statistical comparison of neonatal data with established pediatric data.
Main Results:
- Ventricular activation maximum shifted from the anterior chest to the lower right and then the back during QRS.
- Niche appearance during QRS was significantly earlier in newborns (19.6 msec) than in children (25.7 msec).
- Peak positive potentials shifted leftward during the first week; T wave maps evolved from Type I/II to Type III, with Type III increasing with age.
Conclusions:
- Neonatal QRS maps exhibit distinct spatial and temporal characteristics compared to those of normal children.
- T wave map morphology undergoes significant changes within the first week of postnatal life.
- BSPM provides valuable insights into the dynamic electrophysiological maturation of the neonatal heart.
Abstract:
One hundred body surface isopotential maps for 30 normal infants, ages three hours to seven days, were evaluated. Ventricular activation and recovery were examined. In the early and mid phase of QRS, the maximum moved from the center of the anterior chest to the lower right portion of the anterior chest. In the late phase, the maximum appeared on the back. The niche appeared earlier in normal newborn infants (19.6 +/- 3.9 msec) (mean +/- S.D.) than in normal children (25.7 +/- 4.6 msec) (P less than 0.001). The location of the maximum at the time of peak positive potentials gradually shifted leftward during the first week of life. The 100 T wave maps were classified into three types. During the first day of life, the T wave maps showed type I or II, changing to type II or III a few days after birth. All T wave maps were type III a week after birth. The ratio of type III gradually increased with age. We found that the QRS maps were different from those of normal children and that T wave maps changed within the first week of birth.