Correlation between the signal-averaged electrocardiogram from Holter tapes and from real-time recordings

Signal-averaged electrocardiograms obtained from 3-channel Holter recordings were compared, using the same skin electrodes, with signal-averaged real-time recordings in 32 subjects. The numeric late potential parameters and morphologic appearances correlated closely between the 2 methods. The restricted high frequency response of Holter systems appears not to militate against clinically useful late potential analysis from Holter tape. This study suggests that diagnostic accuracy using real-time 25 to 250-Hz criteria is acceptable for clinical use until criteria derived specifically for Holter applications become available. Holter analysis may confer significant benefits resulting from an ability to perform late potential analysis on the same tape used for conventional arrhythmia analysis, and would allow future studies of possible dynamic changes of late potentials in relation to transient ischemia and spontaneous ventricular tachyarrhythmias.