Body Surface Potential Mapping (BSPM) is a multi-electrode synchronous method for examining electrocardiographic records on the patients’ body surface that allows the assessment of changes in the heart conduction system.

The aim of the study was to visualize and evaluate changes in the intraventricular system in adolescents with T1D.

Patients and methods

Inclusion criteria: age > 12 years, T1D duration >3 years, HbA1c >8%. Exclusion criteria: diagnosis of autonomic neuropathy, heart structural defects, heart failure. BSPM data were processed into map plotting to illustrate differences in ventricular activation time (VAT, isochron lines).

Results

33 teenagers (20 boys), mean age 15.0 ± 2.1 years, T1D from 6.8 ± 4.1 years were included. Mean HbA1c was 9.6 ± 2.0%. In the standard ECG recording abnormalities were not present. The distribution of isolines on the group-mean map plotted for T1D patients only initially resembles the course of isolines on the group-map for normal subjects (N = 30), in whom the electrical impulse stimulating the heart ventricles passes through the atrio-ventricular node, then symmetrically excites the branches of His bundle and finally the Purkinje fibers. In T1D patients, after proper onset of intraventricular stimulation, the isolines reflecting the both ventricles reach higher time values, which indicates problems in the propagation of the ventricular depolarization.

Conclusions

1.

The time values of ventricular stimulation on the maps in T1D indicate a delayed and distorted propagation of activation in the heart conduction system over the left and right ventricle.

2.

The observed changes occurred mostly outside the thoracic area covered by the standard 12-lead ECG registration.

中文翻译：

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青少年 1 型糖尿病的心室内传导系统紊乱。试点研究

体表电位映射 (BSPM) 是一种多电极同步方法，用于检查患者体表的心电图记录，从而可以评估心脏传导系统的变化。

该研究的目的是可视化和评估 T1D 青少年脑室内系统的变化。

患者和方法

纳入标准：年龄>12岁，T1D病程>3年，HbA1c>8%。排除标准：诊断为自主神经病变、心脏结构缺陷、心力衰竭。BSPM 数据被处理成地图，以说明心室激活时间（增值税，等时线）的差异。

结果

包括 33 名青少年（20 名男孩），平均年龄 15.0 ± 2.1 岁，T1D 年龄 6.8 ± 4.1 岁。平均 HbA1c 为 9.6 ± 2.0%。在标准心电图记录中不存在异常。为 T1D 患者绘制的组均值图上的等值线分布最初类似于正常受试者（N  = 30）的组图上的等值线分布，其中刺激心室的电脉冲通过房室节点，然后对称地激发希氏束的分支，最后是浦肯野纤维。在 T1D 患者中，在适当开始心室内刺激后，反映两个心室的等值线达到更高的时间值，这表明心室去极化的传播存在问题。

结论

1.

T1D 图中心室刺激的时间值表明左心室和右心室的心脏传导系统中的激活传播延迟和扭曲。

2.

观察到的变化主要发生在标准 12 导联心电图记录所覆盖的胸部区域之外。