Body surface Laplacian mapping: modeling and clinical application

The purpose of this investigation was to elucidate effects of torso volume conduction on the body surface Laplacian map (BSLM) compared with the body surface potential map (BSPM) by computer modeling, and to test the applicability of body surface Laplacian mapping to the clinical diagnosis of abnormalities in cardiac electrical activity. Volume conductor effects on simulated BSLMs and BSPMs were compared using a spherical conductor model. BSLMs and BSPMs were obtained and studied experimentally in eight patients with cardiac abnormalities, including left bundle branch block (LBBB), premature ventricular depolarizations, (PVDs), and right ventricular (RV) pacemaker. The modeling and experimental studies demonstrate that torso volume conduction has much less smoothing effect on the BSLM than on the BSPM. Preliminary clinical study demonstrates that BSLMs can resolve and image regional myocardial events and can detect abnormal cardiac conduction patterns with high spatial resolution