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[Late potentials and ventricular arrhythmia in patients with chronic coronary heart disease]
F R Eberli1, H P Krayenbühl, S Carli
1Departement für Innere Medizin, Universitätsspital Zürich.
Insights
Late potentials on signal-averaged ECG do not reliably predict ventricular arrhythmias in chronic coronary heart disease patients. This study found no direct link between late potentials and the severity of arrhythmias detected by 24-h Holter monitoring.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Diagnostics
Context:
- Chronic coronary heart disease (CCHD) patients are at risk for complex ventricular arrhythmias.
- Late potentials on signal-averaged ECG (SAECG) are investigated as a potential predictor of these arrhythmias.
- 24-hour Holter monitoring is used to assess the actual burden of arrhythmias.
Purpose:
- To evaluate the predictive value of late potential recordings for complex ventricular arrhythmias in CCHD.
- To compare SAECG findings with arrhythmia data from ambulatory 24-h Holter monitoring.
Summary:
- 101 CCHD patients underwent SAECG and 24-h Holter monitoring.
- Ventricular arrhythmias (non-sustained ventricular tachycardia or ventricular premature beats) were detected in 69 patients.
- Late potential parameters showed high variability and did not significantly correlate with arrhythmia presence or severity; predictability for VT was only 38%.
Impact:
- Late potentials are not a direct or reliable indicator of the extent and severity of arrhythmias in CCHD.
- Findings suggest that SAECG alone may be insufficient for risk stratification of ventricular arrhythmias in this patient population.
- Further research may be needed to identify more accurate predictors of ventricular arrhythmias in CCHD.
Abstract:
To assess the value of late potential recordings in predicting complex ventricular arrhythmias in chronic coronary heart disease, signal-averaged ECG and 24-h Holter were performed in 101 consecutive patients following coronary arteriography. In 69 of 101 patients, non-sustained ventricular tachycardia (VT) (22 patients) or monotopic or polytopic ventricular premature beats (VPB) (47 patients) were detected. When the different patient groups (VT, VPB, no arrhythmias) were compared, the parameters defining the late potentials demonstrated broad variability. Patients with non-sustained ventricular tachycardia showed a tendency to increased late potentials, though this tendency was not significant. In patients with pathologic late potentials the predictability of non-sustained ventricular tachycardia was only 38%. - It is therefore concluded that late potentials in patients with chronic coronary heart disease are not directly linked to the extent and severity of arrhythmias recorded in the ambulatory 24-h Holter.