Document Detail


Identification of ventricular late potentials in the surface electrocardiogram during atrial, atrioventricular sequential, or single-chamber ventricular pacing.
MedLine Citation:
PMID:  10549909     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sudden cardiac death occurs in up to 30% of patients with cardiac pacemakers, caused by ventricular arrhythmias, but in these patients noninvasive risk stratification with Holter, exercise, or standard signal-averaged electrocardiogram is limited. This study investigated whether late potential analysis during cardiac pacing is applicable. In 50 postinfarction patients with documented sustained ventricular tachycardia (VT) and in 50 patients without VT, late potential analysis during sinus rhythm was compared with the corresponding patient's analysis during temporary pacing. During sinus rhythm late potentials were seen in 48 of 50 patients with VT and in 2 of 50 patients without VT. No significant changes were observed during atrial pacing. Modified QRS alignment for signal averaging, QRS endpoint definition, and adjusted cutoff values for abnormality in time and frequency domain analysis allowed retrieval of all late potentials observed during sinus rhythm even in ventricular-paced beats and retrograde conduction. By application of an adjusted analysis to 100 selected patients with permanent pacemakers (50 patients with a history of VT, 50 patients without VT) late potentials were detectable in 44 of 50 patients with VT and in 4 of 50 without VT (sensitivity 88%, specificity 92%). Thus, considering that varying pacing modes, ventricular-paced beats, and retrograde conduction do require modifications of standard late potential analysis, this is an applicable mode for noninvasive risk stratification even in patients with cardiac pacemakers.
Authors:
P Steinbigler; R Haberl; A Knez; G Steinbeck
Related Documents :
7809269 - Silicone gel implant explantation: reasons, results, and admonitions.
1279309 - Therapy with and assessment of class iii antiarrhythmic agents in different patient pop...
3605129 - Relationship of steady-state serum concentrations of amiodarone and desethylamiodarone ...
7596849 - Efficacy of different treatment strategies for neurocardiogenic syncope.
17045899 - Abnormal conduction increases risk of adverse outcomes from right ventricular pacing.
9276769 - Exercise-induced t-wave alternans as a marker of high risk in patients with hypertrophi...
20060259 - Extracardiac findings in cardiac computed tomographic angiography in patients at low to...
7534399 - Fetal haemoglobin variations following hydroxyurea treatment in patients with cyanotic ...
23814239 - The relevance of the radiological signs of acetabular retroversion among patients with ...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  32     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-12-13     Completed Date:  1999-12-13     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  335-46     Citation Subset:  IM    
Affiliation:
Medical Hospital I, University of Munich, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Algorithms
Cardiac Pacing, Artificial*
Death, Sudden, Cardiac / etiology,  prevention & control
Electrocardiography*
Female
Heart Atria / physiopathology
Heart Ventricles / physiopathology
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis*,  physiopathology
Risk Factors
Signal Processing, Computer-Assisted
Tachycardia, Ventricular / diagnosis*,  physiopathology

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


Previous Document:  Effect of pilsicainide, a pure sodium channel blocker, on spiral waves during atrial fibrillation: t...
Next Document:  Paroxysmal supraventricular tachycardia caused by 1:2 atrioventricular conduction in the presence of...