Document Detail


Determinants of arrhythmogenic ventricular activity detected on the body surface QRS in patients with coronary artery disease.
MedLine Citation:
PMID:  6731295     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prevalence of arrhythmogenic ventricular activity (AVA) was investigated in 166 patients with coronary artery disease. Thirty patients had documented ventricular tachycardia (VT)/ventricular fibrillation (VF). Bipolar X, Y, Z leads were signal-averaged and filtered with a 40-Hz, bidirectional, high-pass digital filter. The filtered QRS signals were analyzed for the amplitude of the last 40 and 50 ms; duration of low-amplitude potentials (less than 40 microV) in the terminal portion; and duration of the filtered QRS. A positive AVA test result was defined as the presence of 2 or more abnormal indexes. Of the 30 patients with VT/VF, 66% had positive AVA test results (AVA-positive patients). Of the 136 patients without VT/VF, 25% had positive AVA test results. The following univariate variables showed significant correlation with an AVA-positive test: age, previous myocardial infarction, previous VT/VF, left ventricular wall motion abnormalities and left ventricular ejection fraction. Multivariate stepwise discriminant function analysis revealed that the presence of previous myocardial infarction and history of sustained VT/VF were the only independent determinants of AVA. During electrophysiologic studies, sustained VT/VF could be induced in 77% of the AVA-positive patients (24 of 31) and in 30% of the AVA-negative patients (3 of 10). The survival probabilities for 6, 12 and 18 months of follow-up were 92%, 85% and 85% for the AVA-positive and 97%, 92% and 90% for the AVA-negative patients. Our findings support the concept that a positive AVA test result reflects areas of delayed ventricular activation. The areas of delayed ventricular activation are associated with previous myocardial injury and scar tissue and serve as an anatomic basis for reentry.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
P Denes; E Uretz; P Santarelli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  53     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1984 Jun 
Date Detail:
Created Date:  1984-07-03     Completed Date:  1984-07-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1519-23     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Arrhythmias, Cardiac / complications,  physiopathology*
Coronary Angiography
Coronary Disease / complications,  physiopathology*,  radiography
Electrocardiography / methods*
Female
Heart Ventricles / physiopathology
Humans
Male
Middle Aged
Prognosis
Stroke Volume
Tachycardia / complications,  physiopathology,  radiography
Ventricular Fibrillation / complications,  physiopathology*,  radiography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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