Quantitative analysis of high-frequency components of signal-averaged QRS complex in chinese patients with acute myocardial infarction. A prospective study for prediction of ventricular tachycardia.:A Prospective Study for Prediction of Ventricular Tachyc
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概要
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A prospective study was undertaken of the high-frequency components of the terminal portion of the QRS complex in 38 Chinese patients with acute myocardial infarction (AMI) (mean age 62±5.6 years) within the first week after the acute event (5.5±1.2 days). Another 44 normals served as controls (mean age 57±9.6 years). The electrocardiogram was averaged at a filter band pass of 80-300Hz. The low voltage span (LVS) of the signals less than 40μV in the terminal portion of QRS, the root-mean-square (RMS) voltage (V) of terminal 40 msec of the QRS complex, and the total duration of signal-averaged QRS vector complex were measured in both the normal subjects and patients. The LVS was abnormally prolonged in 16 of 38 patients (42%), and in only 16% of normals (p<0.05). The RMS-V was abnormal (<25μV) in 29 of 38 patients (76%), and in only 20% of normals (p<0.0005), and the signalaveraged QRS vector complex was abnormal (>120msec) in 26 of 38 patients (68%), and only 9% of normals (p>0.005). There was no significant correlation between any of the signal-averaged parameters, the site of AMI and total creative kinase (CK) or CK-MB values. The signal-averaged parameters also showed no relationship to either the cardiothoracic (C/T) ratio or the left ventricular ejection fraction, determined by the Tc-99m pertechnete first pass blood pool technique. Holter ECG monitoring was performed twice in all AMI patients, at 7 to 18 days after the acute event (12 days average) and 3 weeks after the first recording. There were only four episodes of non-sustained ventricular tachycardia (VT), all during the second monitoring period. Three episodes (10%) occurred in patients with positive late potentials (LPs), defined by an RMS-V<25μV in the terminal portion of QRS vector; one episode (11%) occurred in patients with negative LPs (9 patients). Although the incidence of LPs is significantly higher in patients with an AMI than in normal controls, the LPs detected by body surface signal-averaged ECG did not predict the occurrence of in- and out-of-hospital VTs. Thus, after AMI, Chinese patients may not be as prone to develop VTs as are Caucasians. Furthermore, the appearance of LPs is independent of cardiac size and left ventricular ejection fraction.
- International Heart Journal刊行会の論文
著者
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Chen Chung-yin
Division Of Cardiology Kuang-tien General Hospital
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CHANG Mau-Song
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital-Kaohsiung and Taipei
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CHANG Mau-Song
Division of Cardiology, Veterans General Hospital
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CHEN Chung-Yin
Division of Cardiology, Veterans General Hospital
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KAO Tsai
Division of Cardiology, Veterans General Hospital
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YU Beverly
Division of Cardiology, Veterans General Hospital
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