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. 2012 Feb;27(2):251-9.
doi: 10.1007/s00467-011-1982-y. Epub 2011 Aug 11.

Heart ventricular activation in VAT difference maps from children with chronic kidney disease

Krystyna Laszki-Szcząchor  1 , Dorota Polak-Jonkisz, Danuta Zwolińska, Lesław Rusiecki, Anna Janocha, Małgorzata Sobieszczańska
Affiliations

Heart ventricular activation in VAT difference maps from children with chronic kidney disease

Krystyna Laszki-Szcząchor et al. Pediatr Nephrol. 2012 Feb.

Abstract

Children with chronic kidney disease (CKD) are affected by cardiovascular complications, including disturbances in the intraventricular conduction system. Body surface potential mapping (BSPM) is a non-invasive method of assessing the cardioelectrical field. Our aim was to investigate conduction disturbances in young CKD patients using ventricular activation time (VAT) maps. Our study comprised 22 CKD children (mean age: 13.1 ± 2.5 years) treated conservatively and 29 control patients. For each child 12-lead electrocardiogram (ECG) readings were taken, and blood pressure and serum concentrations of iPTH, Pi, t-Ca, creatinine, Fe(+3), ferritin, and Hb, as well as eGFR were measured. All children underwent registration in the 87-lead BSPM system, and group-mean VAT maps and a difference map, which presents statistically significant differences between the groups, were created. The VAT map distribution in CKD patients revealed abnormalities specific to left anterior fascicle block. The difference map displays the areas of intergroup VAT changes, which are of discriminative value in detecting intraventricular conduction disturbances. Intraventricular conduction impairments in the left bundle branch may occur in children with CKD. BSPM enables conduction disturbances in CKD children to be detected earlier than using 12-lead ECG. The difference map derived from the group-mean isochrone maps precisely localizes the sites of disturbed conduction in the heart intraventricular conduction system.

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Figures

Fig. 1
Fig. 1
Scheme of electrodes placement on the thoracic surfaces
Fig. 2
Fig. 2
Ventricular activation time (VAT)-mean map from the control children (C group). a On plane; 3-dimensional view
Fig. 3
Fig. 3
VAT-mean map from the children with chronic kidney disease (CKD) treated conservatively (S group) displaying a pattern of early left anterior fascicle block. a On plane; b 3-dimensional view
Fig. 4
Fig. 4
Difference map: map presenting the significant differences in the mean VAT values between the patient group and the control group. a On plane; b 3-dimensional view
See this image and copyright information in PMC

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