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[Clinical significance of late potential in patients with dilated cardiomyopathy]
Insights
Late potentials (LP) on signal-averaged electrocardiography indicate slow conduction and risk for ventricular arrhythmias. In dilated cardiomyopathy, LPs effectively predict spontaneous and inducible sustained ventricular tachycardia (S-VT).
Area of Science:
- Cardiology
- Electrophysiology
- Medical Diagnostics
Background:
- Signal-averaged electrocardiography identifies late potentials (LP), linked to slow conduction and ventricular arrhythmias.
- LP's utility is known in ischemic heart disease, but its role in dilated cardiomyopathy (DCM) requires clarification.
Purpose of the Study:
- To investigate the clinical significance of LPs in patients with dilated cardiomyopathy.
- To assess the relationship between LPs and clinical characteristics, including ventricular tachycardia inducibility.
Main Methods:
- Studied 34 patients with dilated cardiomyopathy, assessing LPs via signal-averaged electrocardiography.
- Programmed electrical stimulation (PES) was used in 20 patients to evaluate sustained ventricular tachycardia (S-VT) inducibility.
Main Results:
- Late potentials were detected in 20 of 34 DCM patients.
- No significant differences in heart failure, hemodynamics, or mortality were found between LP-positive and LP-negative groups.
- LP-positive patients showed a higher incidence of spontaneous S-VT and a significantly higher rate of S-VT induction via PES.
Conclusions:
- Late potentials are a valuable indicator of S-VT risk in dilated cardiomyopathy.
- LP detection can help identify DCM patients susceptible to ventricular arrhythmias, aiding risk stratification.
Abstract:
Signal-averaged electrocardiography is used to demonstrate low amplitude, high frequency late potential (LP) that represents areas of slow conduction and substrate for reentrant ventricular arrhythmias. Usefulness of LP has been established in patients with chronic ischemic heart disease. However, clinical significance of LP in patients with dilated cardiomyopathy remains to be clarified. We studied the relationships between LP and clinical characteristics in 34 patients with dilated cardiomyopathy. In 20 patients we evaluated the inducibility of sustained ventricular tachycardia (S-VT) using programmed electrical stimulation (PES). LP was detected in 20 of 34 patients. No statistical differences were observed between patients with LP and patients without LP in the incidence of congestive heart failure, hemodynamic parameters and mortality. But, patients with LP had higher incidence of spontaneous S-VT. S-VT was induced in 10 of 15 patients with LP and in none of 5 patients without LP. LP was an excellent indicator of the spontaneous incidence and inducibility of S-VT in patients with dilated cardiomyopathy.