Electrocardiographic body surface potential maps of the QRS of normal children

Electrocardiographic body surface potential maps (BSPM), utilizing 180 active dry electrodes imbedded in an inflatable vest, were obtained in 40 normal children, ages 8 to 18. The potential levels of the maps are displayed as different colors. A qualitative analysis indicated that the onset of right ventricular breakthrough could always be recognized in the upstroke of the QRS by a pseudopod from a right shoulder minimum extending into an anterior maximum, at an average of 24.4 +/- 4.2 msec., for an average QRS duration of 75.0 +/- 7.1 msec. However there was considerable normal variation, particularly in the mid and late QRS. At the time of depolarization of the free walls of the ventricles, the maximum often remained anterior, with an extension posterior, even through the Frank system vectorcardiogram invariably was posterior. Most remarkable was the terminal QRS of the BSPM, where the terminal maximum may be right superior anterior, anterior superior, or right posterior, presumably reflecting the right ventricular outflow tract, the superior septum, or the posterior basal left ventricle.