Document Detail


Usefulness of post-ventriculotomy signal averaged electrocardiograms in congenital heart disease.
MedLine Citation:
PMID:  17145227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Signal-averaged electrocardiography is a sensitive and specific technique for detecting the slow conduction electrophysiologic substrates of reentrant monomorphic ventricular tachycardia. Although well established, the method has not been used for electrophysiologic assessment after right ventriculotomy for the intracardiac repair of congenital heart disease. This 8-year prospective study provided this assessment. Recordings were obtained from 242 post-ventriculotomy patients with congenital heart disease aged 16 to 72 years (139 males, 103 females). Because ventricular volume or pressure overload can prolong the QRS duration, 40 unoperated patients with hemodynamic overload served as controls. Orthogonal X, Y, and Z body surface electrodes were used to detect ventricular late potentials by permitting the examination of portions of the electrocardiogram otherwise obscured by noise and artifacts. Positive signal-averaged electrocardiographic (SAECG) results were based on established criteria derived from 3 time-domain variables calculated by an automated algorithm. Late potentials were detected in 151 of 242 patients (62%) and were significantly higher than controls (p = 0.0001). Radiofrequency ablation of an inducible slow conduction substrate rendered 20 of 23 positive post-ventriculotomy SAECG results negative, and surgical revision of the ventriculotomy scar rendered 19 of 19 positive SAECG results negative. In conclusion, negative SAECG results connote the absence of a reentrant substrate, and therefore, the absence of risk for reentrant monomorphic ventricular tachycardia, whereas positive SAECG results connote the presence of a slow conduction substrate and the potential risk for monomorphic ventricular tachycardia.
Authors:
Joseph K Perloff; Holly R Middlekauf; John S Child; William G Stevenson; Pamela D Miner; Gary D Goldberg
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Publication Detail:
Type:  Journal Article     Date:  2006-10-30
Journal Detail:
Title:  The American journal of cardiology     Volume:  98     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-05     Completed Date:  2007-01-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1646-51     Citation Subset:  AIM; IM    
Affiliation:
Ahmanson/UCLA Adult Congenital Heart Disease Center and Division of Cardiology, Department of Medicine, UCLA School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA. josephperloff@earthlink.net
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Body Surface Potential Mapping
Catheter Ablation
Echocardiography
Electrocardiography*
Electrocardiography, Ambulatory
Electrophysiologic Techniques, Cardiac
Exercise Test
Female
Heart Defects, Congenital / complications,  physiopathology,  surgery*
Heart Ventricles / surgery*
Humans
Male
Middle Aged
Signal Processing, Computer-Assisted*
Tachycardia, Ventricular / diagnosis*,  etiology,  surgery
Tetralogy of Fallot / complications,  physiopathology

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


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