On the estimation of the Laplacian electrocardiogram during ventricular activation.

Body surface Laplacian electrocardiogram (ECG) mapping using a set of disk electrodes is explored by both computer simulation and human experiments in 12 healthy subjects. The Laplacian ECG was estimated from body surface potentials using finite difference estimation algorithms. The performance of the finite difference Laplacian estimators was evaluated by both computer simulation and human experiments. The present experimental results show that the two types of finite difference Laplacian estimates are highly correlated and have a consistent spatial distribution over the anterolateral chest during normal ventricular activation. The present computer simulation and human experiment results suggest the feasibility of estimating the body surface Laplacian maps (BSLMs) from potentials using the finite difference algorithm over the anterior chest in male subjects. The noise levels of the BSLMs over the anterolateral chest were quantitatively compared to the noise levels in corresponding body surface potential maps (BSPMs) in 12 healthy subjects. The simulation and experiment results indicate that the noise to signal ratios in the BSLMs over the anterolateral chest during ventricular activation is about 5 times that of the BSPMs, when no signal processing is performed.