REMARKS TO THE ACTIVATION SEQUENCE INVARIANCE OF QRST INTEGRAL MAPS

摘要

QRST integral maps are considered to be activation sequence invariant and reflect the weighted gradient of action potential area (APa) distribution within the ventricular myocardium, whereas QRS integral maps are related to activation sequence. In our study the validity of QRST invariance was assessed, based on 192-lead BSPMs (648 healthy subjects, 14 WPW, 34 arrhythmia patients, and 124 patients with old MI, 35 with CAD). QRS and QRST integral map-pair association was characterized by the intra-individual correlation coefficients and by the angle difference of the 192 element QRS and QRST integral map vectors. Results are shown in each group for all the group members by Box & Whiskers diagrams. Results revealed that each pathological change in the QRS integral vectors is "followed" by the vector of the QRST integrals with a high correlation (median of 0.6-0.8). The angle of the two vectors is grossly independent of pathology with a median of 40-50(deg). Consequently, long-lasting activation pattern changes (due to old MI or conduction disturbances) causally modify APa distribution, due to remodeling.