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Titolo:
Identification of ventricular late potentials in the surface electrocardiogram during atrial, atrioventricular sequential, or single-chamber ventricular pacing
Autore:
Steinbigler, P; Haberl, R; Knez, A; Steinbeck, G;
Indirizzi:
Univ Munich, Med Hosp 1, D-81366 Munich, Germany Univ Munich Munich Germany D-81366 , Med Hosp 1, D-81366 Munich, Germany
Titolo Testata:
JOURNAL OF ELECTROCARDIOLOGY
fascicolo: 4, volume: 32, anno: 1999,
pagine: 335 - 346
SICI:
0022-0736(199910)32:4<335:IOVLPI>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
SIGNAL-AVERAGED ELECTROCARDIOGRAM; BUNDLE-BRANCH BLOCK; TIME-DOMAIN ANALYSIS; MYOCARDIAL-INFARCTION; RISK STRATIFICATION; HEART-DISEASE; TERMINAL QRS; TACHYCARDIA; DEATH; ECG;
Keywords:
late potentials; pacemaker; sudden cardiac death; signal-averaged electrocardiogram;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Steinbigler, P Univ Munich, Med Hosp 1, Marchioninistr 15, D-81366 Munich,Germany Univ Munich Marchioninistr 15 Munich Germany D-81366 rmany
Citazione:
P. Steinbigler et al., "Identification of ventricular late potentials in the surface electrocardiogram during atrial, atrioventricular sequential, or single-chamber ventricular pacing", J ELCARDIOL, 32(4), 1999, pp. 335-346

Abstract

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, andadjusted 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 (50patients 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.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/09/20 alle ore 17:10:32