Body surface Laplacian mapping of cardiac excitation in intact pigs

Relating body surface electrocardiographic signals to regional myocardial events has been a major effort in cardiac electrophysiology. Conventional electrocardiographic means do not provide sufficient spatial resolution to resolve distributed cardiac electrical activity. The purpose of this investigation was to evaluate and study the validity of a new technique--body surface Laplacian mapping--in a well-controlled experimental setting, and to test the hypothesis that the body surface Laplacian map (BSLM) can resolve normal and abnormal ventricular depolarization patterns and localize the initial site of ventricular depolarization with high spatial resolution. In this study, BSLMs were constructed from direct measurements of the surface Laplacian of the body surface potentials using an array of 64 concentric bipolar Laplacian electrodes. BSLMs were compared to body surface potential maps (BSPMs) during normal and ectopic ventricular activation in intact anesthetized pigs. The BSLM displayed highly localized images of cardiac electrical activity, indicating its ability to resolve myocardial events. The BSLM in pigs identified the pacemaking focus overlying the known location of the epicardial pacing electrode, and imaged the activation sequence associated with exogenous ventricular pacing. In contrast, in all cases the BSPM revealed a diffuse distribution of activity over the chest. The present results suggest that the BSLM provides sufficient spatial resolution to relate body surface recordings to regional myocardial events and is able to detect ventricular depolarization patterns with greater resolution than the conventional BSPM.