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Is the time domain signal-averaged electrocardiogram helpful in patients with ventricular tachycardia without
Y S Orlov1, M A Brodsky, M V Orlov
1University of California, Irvine, Department of Medicine, Orange 92668-3298, USA.
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Signal-averaged electrocardiogram (SAECG) may have limited value in screening for ventricular tachycardia (VT) unrelated to coronary artery disease (CAD) or left ventricular dysfunction. SAECG results in these patients were intermediate, not differentiating VT inducibility.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Screening
Background:
- Signal-average electrocardiogram (SAECG) is used to screen for ventricular tachycardia (VT) in coronary artery disease (CAD) patients.
- The utility of SAECG in VT patients without CAD or left ventricular dysfunction is not well-established.
Purpose of the Study:
- To evaluate the screening value of SAECG in patients with VT but without structural heart disease.
- To compare SAECG findings in these patients against normal controls and CAD patients with VT.
Main Methods:
- Time-domain SAECG analysis was performed using 25, 40, and 80 Hz filters.
- 35 patients with symptomatic VT and no structural heart disease were compared with 10 normal controls and 10 CAD patients with inducible VT.
Main Results:
- SAECG data in patients without structural heart disease were intermediate between normal controls and CAD patients.
- No SAECG criterion effectively differentiated between inducible and noninducible VT.
- SAECG results showed no concordance with other arrhythmia testing.
Conclusions:
- Signal-averaged electrocardiography appears to have limited screening value for VT unrelated to CAD or left ventricular dysfunction.
- Further research may be needed to identify reliable screening methods for this patient group.
Abstract:
The signal-average electrocardiogram (SAECG) has been a screening method for identifying patients at risk for ventricular tachycardia (VT) in the setting of coronary artery disease (CAD). Its significance in patients with VT unrelated to CAD or left ventricular dysfunction is undetermined. In order to define the value of SAECG in this patient population further, we compared the time domain SAECG at 25, 40, and 80 Hz filters in 35 patients with clinically symptomatic VT in the absence of structural heart disease was compared with 10 normal controls and 10 patients with CAD and inducible VT. SAECG data in patients without structural heart disease were intermediate between normal controls and patients with CAD. No single or combined SAECG criterion helped to differentiate between patients with inducible and noninducible VT. There was no concordance to other arrhythmia testing. It was concluded that signal-averaged electrocardiography may have little screening value in VT unrelated to CAD or left ventricular dysfunction.