Beat-to-beat interplay of heart rate, ventricular depolarization, and repolarization

Kozmann, György; Haraszti, Kristóf; Préda, István

doi:10.1016/j.jelectrocard.2009.08.003

« Previous Next »Journal of Electrocardiology
Volume 43, Issue 1 , Pages 15-24, January 2010

Beat-to-beat interplay of heart rate, ventricular depolarization, and repolarization

György Kozmann, DSc
- Department of Electrical Engineering and Information Systems, University of Pannonia, Veszprém, Hungary
- Department of Biomedical Engineering, Research Institute for Technical Physics and Materials Science of the Hungarian Academy of Sciences, Budapest, Hungary
- Corresponding author. Department of Electrical Engineering and Information Systems, University of Pannonia, H-8201 P.O. Box 158, Veszprém, Hungary.
Kristóf Haraszti, MSc
- Department of Biomedical Engineering, Research Institute for Technical Physics and Materials Science of the Hungarian Academy of Sciences, Budapest, Hungary
- IQSYS Computing, member of Hungarian Telekom Group, Budapest, Hungary
István Préda, MD, DSc
- Department of Cardiology, State Health Center, Budapest, Hungary
- Cardiovascular Center, Semmelweis University, Budapest, Hungary

Received 23 September 2008 published online 12 October 2009.

Abstract

To improve malignant arrhythmia risk stratification, the causal and random components of spatiotemporal dynamics of heart rate (RR distances), ventricular depolarization sequence, and repolarization disparity were studied based on body surface potential map records taken for 5 minutes, in resting, supine position on 14 healthy subjects (age range, 20-65 years) and on 6 arrhythmia patients (age range, 59-70 years). Beat-to-beat QRS and QRST integral maps, Karhunen-Loève (KL) coefficients, RR, and nondipolarity index time series were computed. Tight relationship was found between RR and QRS integrals in healthy subjects with less association in arrhythmia patients. Tight KL-domain multiple linear association (r² > 0.72) was found between the QRS and QRST integral dynamics (ie, depolarization sequence and repolarization disparity). Beat-to-beat probability of the generation of significant nondipolarity index spikes was proportional to the QRST KL-component standard deviations (SD_i) and inversely proportional with the mean dipolar KL components (M_i) of the average QRST integral map.

Keywords: Repolarization disparity, Depolarization sequence, Body surface potential maps, Arrhythmia vulnerability, Heart rate variability