Prediction of Accessory Pathway Locations in Wolff-Parkinson-White Syndrome with Body Surface Potential Laplacian Maps. A Siumulation Study.

An electrocardiographic computer simulation was conducted to study the feasibility of predicting accessory pathway locations in Wolff-Parkinson-White (WPW) syndrome with body surface potential Laplacian maps. Three-dimensional, realistically-shaped heart and torso models were used. Ten accessory pathways (APs) around the atrioventricular ring corresponding to Gallagher et al. were set in the heart model, and body surface Lapacian and potential maps of WPW syndrome with single or multiple APs were simulated and compared to each other. In simulations with a single AP in the anterior walls, the maximum-minimum pairs in Laplacian maps appeared to be similar to those in potential maps with respect to their locations and orientations, but the maximum-minimum pairs in Laplacian maps were sharper and more localized than in potential maps. In simulations with a posterior AP or multiple APs, the maximum-minimum pairs in the Laplacian maps showed features correlative to the AP locations, but no such features were found in potential maps. These results suggest the possibility of using Laplacian maps, as a non-invasive method for predicting accessory pathways locations in WPW syndrome.