A noninvasive method for locating a cardiac dipolar source in humans

A noninvasive method for locating isolated areas of cardiac electrical activity, such as an ectopic focus, is introduced and evaluated. Surface electric potentials due to the source are recorded at 20-25 points on the chest. Each chest is measured and its configuration is approximated by a grid of 126 points. A computer program utilizes these data to calculate the x, y, z coordinates of the cardiac source, and this calculated location is displayed on the bi-plane chest x-rays of the patient. Errors that may occur in other methods that utilize average torso shape and average heart position are eliminated in the proposed method. The method was evaluated by using it for locating the electrodes of implanted pacemakers from their "spikes" in the ECG's, and also from the potentials at the onset of the induced QRS complexes. The results were compared with bi-plane x-rays of the same patients. It was found that the average errors in locating the electrodes from their "spikes" in the ECG's were 1.3 cm in the frontal view and 1.4 cm in the lateral view. The errors in locating the paced myocardial area at the beginning of the QRS complex were similar. The errors in the lateral view are systematic and may be attributed to the effects of the intracavity blood volume (Brody's effect), which are neglected in this method.