Noninvasive identification of three-dimensional myocardial infarctions from inversely reconstructed equivalent current density

The study presents a new approach to non-invasively identify the 3-dimensional MI substrate from the equivalent current densities (ECDs) that is inversely reconstructed from body surface potential maps (BSPMs). The MI substrate was characterized using a threshold determined from the ECD magnitude. A total of 114 sites of transmural infarctions, 91 sites of epicardial infarctions, and 36 sites of endocardial infarctions were simulated. The results show that: 1)With 205 BSPM electrodes and 10 μV Gaussian white noise, the averaged accuracies for transmural MI are sensitivity = 83.4%, specificity = 82.2%, and the distance between the centers of gravity (DCG) = 6.5mm. Epicardial infarctions (sensitivity = 81.6%, specificity = 75.8%, and DCG = 7.5mm) obtained similar accuracies to endocardial infarctions (sensitivity = 80.0%, specificity = 77.0%, and DCG = 10.4 mm). A reasonably good imaging performance was obtained under a higher noise level, fewer BSPM electrodes, and mild volume conductor modeling error, respectively. The results suggest that this method is capable of imaging the transmural and surface infarction.