Document Detail


Late potential analysis: is a mathematically-derived X,Y,Z lead system comparable to a true orthogonal X,Y,Z lead system?
MedLine Citation:
PMID:  12431307     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Analysis of ventricular late potentials (LP) with signal-averaged ECG (SAECG) using three bipolar, orthogonal X,Y, Z leads is a validated method of risk-stratification in patients prone to ventricular tachycardia. The aim of this study was to validate a ECG system, which allows LP analysis using X,Y, Z leads mathematically derived from the standard 12-lead ECG. METHODS AND RESULTS: In 36 patients (age 56 +/- 12 years, coronary artery disease 71%, LVEF 46 +/- 14%) with known or suspected ventricular tachyarrhythmia, two consecutive SAECGs were recorded, one with mathematically derived and another one with true X,Y, Z leads. Time domain measurements with these different lead systems were compared using linear regression analysis and "Bland-Altman" plots. Correlation was good (r = 0.92) for the filtered QRS complex duration, but poor for the terminal QRS amplitude (RMS) and duration (LAS) criteria (r = 0.66 and 0.61, respectively; P < 0.0001). Defining LPS as present if at least two of the three time domain criteria were abnormal, the result matched in 28 (78%), but differed in 8 (22%) patients. CONCLUSION: SAECG using X,Y, Z leads mathematically derived from the standard 12-lead ECG compared to true bipolar X,Y, Z leads show a close correlation in filtered QRS duration, but can differ considerably in the other time domain measurements, resulting in different interpretation of LP analysis in 22%. Therefore, SAECG registration should currently be performed with true X,Y, Z leads, until the accuracy of other approaches is validated.
Authors:
Thomas A Cron; Michael J Zellweger; Peter T Buser; Matthias E Pfisterer; Stefan Osswald
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Publication Detail:
Type:  Festschrift; Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  7     ISSN:  1082-720X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-11-14     Completed Date:  2003-04-14     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  302-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University Hospital, Petersgraben 4, CH-4031 Basel, Switzerland. tcron@uhbs.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Disease / diagnosis*
Electrocardiography*
Electrodes
Female
Humans
Linear Models
Male
Mathematical Computing*
Middle Aged
Prognosis
Prospective Studies
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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