Key result
Using a smaller increment of 0.02 mV between isopotential lines reveals that an anterior minimum precedes the anterior maximum in the youngest subjects, challenging traditional QRS onset criteria.
Cross-Sectional (n=110)
A smaller voltage increment (0.02 mV) in body surface potential mapping reveals that initial ventricular depolarization in children begins with an anterior minimum, suggesting current criteria for QRS onset may need reconsideration.
May prompt reevaluation of pediatric QRS onset; leaves open whether revised criteria improve accuracy.
Group mean isopotential maps of initial parts of ventricular depolarization (QRS complex) in 4 age groups (10, 14, 19 and 22 years) of young healthy subjects, females and males, were analyzed using different increments between isopotential lines. It was found that the increment 0.1 mV masks some features of the maps, which are seen only by smaller increment (0.02 mV): the time of appearance of maximum and minimum on the anterior chest, smaller voltage values of the extrema as usually published, minimum dominating over maximum in the youngest groups. Therefore, the often applied criterion for the QRS onset - the increasing maximum on the anterior chest - should be reconsidered at least when it concerns the isopotential maps of children.
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Kozlíková et al. (2019) conducted a cross-sectional in Healthy volunteers (n=110). Isopotential map increment of 0.02 mV vs. Isopotential map increment of 0.1 mV was evaluated on Appearance of maximum and minimum on the anterior chest during the initial parts of the QRS complex. Using a smaller increment of 0.02 mV between isopotential lines reveals that an anterior minimum precedes the anterior maximum in the youngest subjects, challenging traditional QRS onset criteria.
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