Total Body Surface Potential Mapping During Exercise: QRS‐T‐wave Changes in Normal Young Adults

Total body surface potential distributions were recorded from 20 normal young adults, 20–35 years old, during multistage maximal exercise testing on a bicycle ergometer. Using a system for measuring total body surface potential distributions from measurements at 24 locations, high-quality potential maps were obtained during exercise without requiring wave form averaging or special modes of exercise. Serial maps recorded at 1-msec intervals throughout QRS-T during exercise and during recovery from exercise were compared with corresponding maps recorded with the subjects at rest. During and after exercse, consistent changes appeared in the map patterns during early QRS and the ST segment and in the magnitude of the T-wave potentials. Increases in QRS duration (0–10 msec) also appeared during exercise. The changes in map patterns during early QRS in exercise strongly suggested changes in the initial sequence of activation in the ventrides. The results demonstrate the importance of analyses of total body surface potential distributions in understanding ECG changes during exercise.

[1]  E. Lepeschkin Exercise Tests in the Diagnosis of Coronary Heart Disease , 1960, Circulation.

[2]  E. Simonson USE OF THE ELECTROCARDIOGRAM IN EXERCISE TESTS. , 1963, American heart journal.

[3]  F. Kornreich,et al.  Surface maps and myocardial scanning at rest and during exercise: comparison with coronary angiography. , 1976, Archives internationales de physiologie et de biochimie.

[4]  G. S. Herman-Giddens,et al.  Selection of the number and positions of measuring locations for electrocardiography. , 1971, IEEE transactions on bio-medical engineering.

[5]  M. Simoons,et al.  Estimation of the Probability of Exercise-induced Ischemia by Quantitative ECG Analysis , 1977, Circulation.

[6]  B. Chaitman,et al.  The Importance of Clinical Subsets in Interpreting Maximal Treadmill Exercise Test Results: the Role of Multiple-Lead ECG Systems , 1979, Circulation.

[7]  I. Åstrand,et al.  The frank lead exercise electrocardiogram. A quantitative study based on averaging technic and digital computer analysis. , 1965, Acta medica Scandinavica.

[8]  J. Weiss,et al.  Exercise stress testing. , 1977, Circulation.

[9]  B. Surawicz,et al.  Characteristics of true-positive and false-positive results of electrocardiographic Master twostep exercise tests. , 1958, The New England journal of medicine.

[10]  K. Fox,et al.  Precordial electrocardiographic mapping after exercise in the diagnosis of coronary artery disease. , 1979, The American journal of cardiology.

[11]  R A Bruce,et al.  Quantitation of QRS and ST segment responses to exercise. , 1966, American heart journal.

[12]  B. Taccardi,et al.  Distribution of Heart Potentials on the Thoracic Surface of Normal Human Subjects , 1963, Circulation research.

[13]  R. Bruce,et al.  Variations in Electrocardiographic Responses during Exercise: Studies of Normal Subjects under Unusual Stresses and of Patients with Cardiopulmonary Diseases , 1951, Circulation.

[14]  R. E. Mason,et al.  A new system of multiple-lead exercise electrocardiography. , 1966, American heart journal.

[15]  P. Greenberg,et al.  Significance of changes in R wave amplitude during treadmill stress testing: angiographic correlation. , 1978, The American journal of cardiology.

[16]  Variation of QRS amplitude in exercise ECG as an index predicting result of physical training in patients with coronary heart disease. , 1973, Acta medica Scandinavica.

[17]  J. A. Abildskov,et al.  Limited Lead Selection for Estimation of Body Surface Potential Maps in Electrocardiography , 1978, IEEE Transactions on Biomedical Engineering.

[18]  H. G. Lloyd-Thomas THE EFFECT OF EXERCISE ON THE ELECTROCARDIOGRAM IN HEALTHY SUBJECTS , 1961, British heart journal.

[19]  R C Barr,et al.  Isopotential Body Surface Mapping in Subjects of All Ages: Emphasis on Low-Level Potentials with Analysis of the Method , 1979, Circulation.

[20]  M. Simoons,et al.  Gradual Changes of ECG Waveform During and After Exercise in Normal Subjects , 1975, Circulation.

[21]  G E Dower,et al.  Ischemic Polarcardiographic Changes Induced By Exercise: A New Criterion , 1973, Circulation.

[22]  R. Stein,et al.  Continuous ventricular dimensions in man during supine exercise and recovery. An echocardiographic study. , 1978, The American journal of cardiology.

[23]  A. Master,et al.  The electrocardiogram after standard exercise as a functional test of the heart , 1942 .

[24]  P. Greenberg,et al.  Evaluation of R Wave Amplitude Changes versus ST-Segment Depression in Stress Testing , 1978, Circulation.

[25]  K. Fox,et al.  A method for praecordial surface mapping of the exercise electrocardiogram. , 1978, British heart journal.

[26]  R. Ideker,et al.  Left Precordial Isopotential Mapping during Supine Exercise , 1977, Circulation.

[27]  E. Kentala,et al.  Response of R wave amplitude to postural changes and to exercise. A study of healthy subjects and patients surviving acute myocardial infarction. , 1975, Annals of clinical research.

[28]  G. E. Newman,et al.  Cardiac Function at Rest and During Exercise in Normals and in Patients with Coronary Heart Disease: Evaluation by Radionuclide Angiocardiography , 1978, Annals of surgery.

[29]  J. .. Abildskov,et al.  Clinically Practical Lead Systems for Improved Electrocardiography: Comparison with Precordial Grids and Conventional Lead Systems , 1979, Circulation.

[30]  Brunotaccardi Body Surface Distribution of Equipotential Lines during Atrial Depolarization and Ventricular Repolarization , 1966 .

[31]  H N Keiser,et al.  Electrocardiogram baseline noise estimation and removal using cubic splines and state-space computation techniques. , 1977, Computers and biomedical research, an international journal.

[32]  R C Barr,et al.  Origin of Epicardial ST‐T Wave Potentials in the Intact Dog , 1976, Advances in cardiology.

[33]  Predicting coronary artery disease with treadmill stress testing: changes in R-wave amplitude compared with ST segment depression. , 1979, Journal of electrocardiology.

[34]  R. B. Warren,et al.  Body Surface Low-Level Potentials During Ventricular Repolarization with Analysis of the ST Segment , 1979, Circulation.

[35]  S. Bellet,et al.  Radioelectrocardiographic Changes during Strenuous Exercise in Normal Subjects , 1962, Circulation.

[36]  R C Barr,et al.  The design of a real-time computer system for examining the electrical activity of the heart. , 1976, Computers and biomedical research, an international journal.