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Statistical analysis of body surface electrocardiographic maps in ischemic heart disease

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Bell, Anthony James (1993) Statistical analysis of body surface electrocardiographic maps in ischemic heart disease. PhD thesis, University of Tasmania.

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Abstract

Body surface electrocardiographic mapping is a technique for recording the
thoracic electrical potentials generated by the cardiac cycle and transmitted to the
body surface. The body surface map emphasizes the spatial distribution of the
cardiac electrical potentials rather than the time magnitude relationship of the
standard electrocardiogram. The body surface map contains more information than
the standard electrocardiogram and in a different format. This thesis addresses the
following questions:
1. is the additional information contained in the body surface map of clinical
significance in myocardial infarction ?
2. is the display format and thus the application of topographical statistics of
clinical benefit in myocardial infarction?
3. is the addition information able to detect coronary artery disease in patients
presenting with chest pain ?
Detailed analysis of the body surface map in acute inferior wall myocardial
infarction predicted the clinical course of the patient, one map pattern being
associated with a high mortality and morbidity, giving a guideline to immediate
therapy. The area of ST segment elevation corresponds to the the area of eventual
Q wave formation in acute inferior wall myocardial infarction. Thus the body
surface map may be useful in assessing reperfusion by thrombolytic agents in acute
myocardial infarction.
In acute anterior wall myocardial infarction the body surface map was
diagnostic but only moderately predictive of the eventual outcome. Again the area
of ST segment elevation matched the area of Q wave formation and thus the body
surface map may be of value in assessing reperfusion.
The body surface mapping was unable to differentiate patients with and without
coronary artery disease who had normal standard electrocardiograms. The body
surface map was useful in differentiating patients with acute or old myocardial
infarction from normal patients but did not detect coronary artery disease in the
absence of myocardial damage.
The information content of the body surface is increased if an accurate inverse
transformation can be used to calculate the epicardial potentials in the clinical
situation. To prove that epicardial potentials are accurately calculated, comparison
of the area of myocardial damage to the calculated epicardial area of ST segment
elevation was made using thallium scanning. This demonstrated a good correlation
demonstrating that the inverse transformation was accurate. The technique is
adding a new dimension to the understanding of the origin of the
electrocardiogram.
Body surface mapping is an easily performed clinical investigation that adds
information in the assessment of the patients with myocardial infarction.

Item Type: Thesis (PhD)
Keywords: Coronary heart disease, Body surface mapping
Copyright Holders: The Author
Copyright Information:

Copyright 1993 the Author - The University is continuing to endeavour to trace the copyright
owner(s) and in the meantime this item has been reproduced here in good faith. We
would be pleased to hear from the copyright owner(s).

Additional Information:

Includes bibliographical references. Thesis (M.D.)--University of Tasmania, 1994. Spine title: Statistical analysis of body surface maps

Date Deposited: 25 Nov 2014 00:45
Last Modified: 11 Mar 2016 05:55
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