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Recent progress of Holter-based late potential for predicting serious cardiac events and its implications and future
Kenichi Hashimoto1, Naomi Harada1
1Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
Insights
Holter electrocardiogram-measured late potentials (H-LP) show promise for detecting lethal arrhythmias and sudden cardiac death. Addressing noise and diurnal variations is key for H-LP
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Late Potential (LP) detection is crucial for identifying lethal arrhythmias.
- Holter electrocardiogram-measured late potentials (H-LP) offer a new approach for LP assessment.
Purpose of the Study:
- To review and clarify unresolved aspects of H-LP.
- To guide future research and enhance clinical utilization of H-LP.
Main Methods:
- Review of existing literature on H-LP.
- Analysis of H-LP parameters, including diurnal variations and noise handling.
Main Results:
- H-LP shows potential for detecting sudden cardiac death, especially in ischemic heart disease.
- Combining H-LP with non-sustained ventricular tachycardia may improve accuracy.
- H-LP parameters exhibit diurnal variations in both healthy and cardiac patients.
Conclusions:
- H-LP is a promising mainstream test for LP detection.
- Challenges include managing noise during daily activities and establishing reference values considering diurnal variations.
- Addressing these challenges will improve H-LP viability and clinical application for cardiovascular health management.
Abstract:
Late potential (LP) has recently been measured using Holter electrocardiogram (H-LP), and accumulating evidence suggests that it is a useful approach for detecting lethal arrhythmias and sudden cardiac death, especially in cases of ischemic heart disease. In this review, our primary objective was to advance the understanding and utilization of H-LP by elucidating the existing unresolved aspects, thereby serving as a guide for future research in this domain. Particularly, the combination of H-LP with non-sustained ventricular tachycardia, rather than LP alone, may improve the accuracy of the test. H-LP parameters show diurnal variations in both patients with cardiac disease and healthy individuals. Although H-LP shows promise as the future mainstream LP test, there are several problems; specifically, handling noise levels when H-LP is performed in unrestricted daily activities. Additionally, a reference value that considers diurnal variations has not yet been established. These challenges need to be addressed to improve the viability and clinical use of H-LP. By incorporating H-LP into routine assessments, healthcare practitioners can gain valuable insights into the cardiovascular health of their patients, facilitating timely interventions and better disease management.
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