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    
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.
P Steinbigler; R Haberl; A Knez; G Steinbeck
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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    
Medical Hospital I, University of Munich, Germany.
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MeSH Terms
Cardiac Pacing, Artificial*
Death, Sudden, Cardiac / etiology,  prevention & control
Heart Atria / physiopathology
Heart Ventricles / physiopathology
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

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