Multipolar QRST isointegral maps and QT dispersion in old myocardial infarction.

UNLABELLED: Chronic myocardial infarction (CMI) may create, due to structural heterogeneity, abnormal electrophysiological substrates which trigger re-entrant life-threatening ventricular arrhythmias.

METHODS

Electrical instability is assessed using body surface mapping (BSM) [multipolar isointegral QRST maps (mp I(QRST))] and 12-lead ECG (QT dispersion: QTd: the difference between maximal and minimal QT interval). The aim was to find the relation between mp I(QRST) and QTd in CMI patients.

RESULTS

The 32 CMI patients, underwent 12-lead ECG and 64-lead BSM. The 80% (25) of the patients had mp I(QRST) maps. QTd was larger in patients with mp than those with dipolar maps (dp): 170 +/- 20 ms in mp vs 94 +/- 19 ms in dp, respectively. The latter, mp I(QRST) was associated with a decrease of maximum and a stronger minimum.

CONCLUSIONS

Multipolar I(QRST) is associated with a loss of maximum values and increased absolute values of the minimum in CMI patients. I(QRST) and QTd provide similar information in predicting postinfarction arrhythmia risk.