Non-invasive imaging of epicardial electrograms during controlled myocardial ischemia

Electrocardiographic potentials measured on the body surface may be used to estimate electric potentials on the epicardial surface. The objective of this study was to refine this estimation so as to recreate temporal epicardial electrograms from body surface mapping data recorded during controlled myocardial ischemia. A boundary-element inverse solution was refined by implementing the Composite Regional Constraint. Complex multiple-dipole sources verified the advantages of using this technique. Epicardial electrograms were reconstructed from body surface maps recorded in 18 patients with single vessel coronary artery disease who were undergoing percutaneous transluminal coronary angioplasty (LAD=7; RCA=9, Cx=2). Localized electrogram changes between maps recorded at rest and during balloon inflation identified the occluded artery, with the amount of change increasing as the inflation progressed.