Serial signal-averaged electrocardiography in children after cardiac transplantation

In patients with myocytolysis detected in endomyocardial biopsy, there is a tendency towards a shift of ventricular electrical axes from normal to strain pattern on surface ECG. Their 12-lead signal-averaged electrocardiogram (SAECG) show a significant increase in filtered QRS duration (QRSD) compared with those with specimens without myocytolysis. Late potentials were generally found more frequently in individual SAECG leads than in the vector magnitude. An increase in filtered QRSD and the presence of late potentials compared with a baseline study emphasizes the need for endomyocardial biopsy. Consequently, no change in these parameters may preclude the indication for endomyocardial biopsy.