Increasing averaging beats improves the test accuracy on Holter-based late potentials in patients with myocardial
Kenichi Hashimoto1, Naomi Harada1, Motohiro Kimata1
1Department of General Medicine, National Defense Medical College, Tokorozawa, Japan.
Insights
Increasing Holter-based late potentials (H-LPs) averaging beats improves prediction of fatal cardiac events in post-myocardial infarction (MI) patients. This method enhances H-LP sensitivity for identifying high-risk individuals.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Diagnostics
Background:
- Holter-based late potentials (H-LPs) are increasingly linked to fatal cardiac events.
- Conventional real-time late potential (LP) recording has lower noise than H-LP.
- Methods to reduce H-LP noise by increasing averaging beats remain unexplored.
Purpose of the Study:
- To investigate the efficacy of increasing averaging beats for reducing noise in H-LPs.
- To assess the impact of increased averaging beats on H-LP detection and parameter values.
- To determine if this technique improves the prediction of fatal cardiac events in post-myocardial infarction (MI) patients.
Main Methods:
- 104 post-MI patients and 86 controls were enrolled.
- H-LPs were measured twice, with averaging beats increased from 250 to 800.
- LP analysis was performed at various beat averaging increments (250, 300, 400, 500, 600, 700, 800).
Main Results:
- Noise levels in H-LPs significantly decreased as averaging beats increased across all groups.
- In the MI-VT group, H-LP positivity and parameter deterioration increased with higher averaging beats.
- H-LP rates and parameters remained stable in MI non-VT and control groups with increased averaging beats.
Conclusions:
- Increasing averaging beats in H-LP analysis reduces noise.
- This technique enhances the sensitivity for detecting late potentials in post-MI patients.
- Higher averaging beats improve the prediction of fatal cardiac events in MI patients.
Background:
The prevalence of Holter-based late potentials (H-LPs) in cases of fatal cardiac events has increased. Although the noise level of H-LP is higher than that of conventional real-time late potential (LP) recording, a procedure to reduce the noise severity in H-LP by increasing the averaging beats has not been investigated.
Methods:
We enrolled 104 patients with post-myocardial infarction (MI) and 86 control participants. Among the patients, 30 reported sustained ventricular tachycardia (VT), and the remaining 74 had unrecorded VT. H-LPs were measured twice in all groups to evaluate the efficacy of increasing the averaging beats for H-LPs. Thereafter, the average of LP was calculated at 250 (default setting), 300, 400, 500, 600, 700, and 800 beats.
Results:
Across all three groups (MI-VT group, MI non-VT group, and control group), the noise levels significantly decreased in consonance with the increase in averaging beats. In the MI-VT group, the H-LP positive rate considerably increased with the increase in the averaging beats from 250 to 800 both at night and daytime. In the MI-VT group, the LP parameters significantly deteriorated, which led to a positive judgment corresponding to the increment of the averaged night and day beats. The H-LP positive rates were unchanged in the MI non-VT and control groups, while the LP parameters remained consistent, despite the increased averaging beats in the MI non-VT and control groups.
Conclusion:
Increasing the calculated averaging beats in H-LPs can improve the sensitivity of predicting fatal cardiac events in patients with MI.
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