Influence of clinical and hemodynamic characteristics on signal-averaged electrocardiogram in postoperative tetralogy of Fallot

Vaksmann, Guy; Kohen, M; Lacroix, Dominique; Kacet, Salem; Breviere, G. M.; Rey, Christian; Dupuis, C

doi:10.1016/0002-9149(93)90798-h

Cited by 12 publications

(1 citation statement)

References 20 publications

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“…This association was not found for the standard QRS duration, suggesting that at this early asymptomatic stage, signal averaged ECG findings are more sensitive predictors of ventricular arrhythmias. Age might have influenced fltQRS duration,18but in our study there was no difference in mean age between the two groups (table 1). We also showed that non-sustained ventricular tachycardia was significantly associated with a higher RD:LD ratio and possibly with low amplitude signal duration; however, additional analysis showed that fltQRS duration, RD:LD ratio, and low amplitude signal duration were confounding variables for the presence of non-sustained ventricular tachycardia.…”

Section: Discussioncontrasting

confidence: 53%

Echocardiographic and signal averaged ECG indices associated with non-sustained ventricular tachycardia after repair of tetralogy of Fallot

Brili

Aggeli²,

Gatzoulis³

et al. 2001

Heart

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Objective-To identify any possible association between diVerent readily available non-invasive indices and potential malignant ventricular arrhythmias in patients with repaired tetralogy of Fallot. Design-27 consecutive patients, mean (SD) age 27.3 (11.7) years, were studied 15.7 (6.7) years after corrective surgery for tetralogy of Fallot, using 12 lead ECG, 24 hour Holter recordings, signal averaged ECG, and echocardiography. The following variables were measured: standard QRS duration, filtered QRS duration (fltQRS), low amplitude signal duration, and root mean square voltage of the last 40 ms of the fltQRS (RMS-40), as well as right ventricular systolic pressure, right ventricular ejection fraction, and the ratio of the maximum short axis diameters of the right and left ventricles (RD:LD). Results-All patients had right bundle branch block, with a mean QRS duration of 137.1 (14.9) ms. There were no patients with sustained arrhythmia. Five patients had runs of non-sustained ventricular tachycardia (group A) and the other 22 patients did not (group B). Univariate analysis showed that fltQRS and RD:LD ratio were significantly associated with nonsustained ventricular tachycardia. In addition, a fltQRS > 148 ms, low amplitude signal > 32.5 ms, RMS-40 < 23 µV, and RD:LD ratio > 1.05 were cut oV points with a high sensitivity for detecting patients with non-sustained ventricular tachycardia. Conclusions-Abnormal signal averaged ECG and echocardiographic variables are associated with potentially malignant ventricular arrhythmias on the Holter recordings in asymptomatic patients with repaired tetralogy of Fallot. (Heart 2001;85:57-60)

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Section: Discussioncontrasting

confidence: 53%

Echocardiographic and signal averaged ECG indices associated with non-sustained ventricular tachycardia after repair of tetralogy of Fallot

Brili

Aggeli²,

Gatzoulis³

et al. 2001

Heart

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Signal-Averaged Electrocardiography in Normal Newborn infants

et al. 2004

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Signal-averaged electrocardiograms (SAECGs) were recorded with bipolar orthogonal and standard 12-lead settings in 29 term healthy newborn infants. SAECGs performed with the two lead configurations were similar in quality and quantity. For the duration of the QRS complex (QRSD), the upper limit of normality for newborn infants can be set to 100 ms. It is similar in individual bipolar orthogonal and individual standard 12-lead recordings as well as in filtered QRSD in the vectorcardiograms (the vector magnitude, VM, and the sum of extremity leads). In individual leads of bipolar orthogonal and standard 12-lead recordings, root-mean-square voltage of the terminal 40 ms of the QRS complex (RMS40) is widely scattered and unsuitable as discriminant variable. For VM and the sum of the extremity leads, the same reference values for RMS40 and duration of low-amplitude signal can be used as applied in adults. Individual lead recordings provide complementary information in addition to vectorcardiograms. There are practical advantages using standard 12-lead compared to conventional bipolar orthogonal configurations. The widespread use of standard 12-lead ECG in routine medical practice makes its utility advantageous also in performing signal-averaged electrocardiography.

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Signal-Averaged Electrocardiogram May Be a Beneficial Prognostic Procedure in the Postoperative Follow-Up Tetralogy of Fallot Patients to Determine the Risk of Ventricular Arrhythmias

2007

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Early detection of arrhythmias after congenital heart disease surgery is important because it can help decrease morbidity and mortality. Standard electrocardiograms (ECGs) contain frequencies between 0.05 and 100 Hz, but higher frequencies are also present. Using high-resolution technology, the highest amplitudes of these high-frequency components within the QRS complex can be recorded and analyzed. We studied the relationship between ventricular late potentials, ventricular arrhythmias and right ventricular systolic pressure in 22 patients who underwent tetralogy of Fallot repair (mean follow-up, 40.1 +/- 33.5 months). Holter ECG monitoring and signal-averaged electrocardiograms (SAECGs) were performed. SAECG parameters studied included the duration of the filtered QRS, the duration of terminal QRS below 40 muV, and the root mean square amplitude of the terminal 40 msec. Cardiac catheterization was performed on 19 patients. Eighteen healthy volunteers were studied as a control. Ventricular arrhythmias were found in 13 patients; right ventricular systolic hypertension was found in 1 patient. No significant residual ventricular septal defects were detected. Eight patients had ventricular late potentials. Right ventricular systolic pressure did not differ significantly between patients with or without late potentials. There were significant differences between patients with ventricular arrhythmias and healthy volunteers; filtered QRS duration was significantly longer in patients with ventricular arrhythmias. SAECG may be beneficial in determining ventricular arrhythmia risk in tetralogy of Fallot patients postoperatively.

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Influence of clinical and hemodynamic characteristics on signal-averaged electrocardiogram in postoperative tetralogy of Fallot

Cited by 12 publications

References 20 publications

Echocardiographic and signal averaged ECG indices associated with non-sustained ventricular tachycardia after repair of tetralogy of Fallot

Echocardiographic and signal averaged ECG indices associated with non-sustained ventricular tachycardia after repair of tetralogy of Fallot

Signal-Averaged Electrocardiography in Normal Newborn infants

Signal-Averaged Electrocardiogram May Be a Beneficial Prognostic Procedure in the Postoperative Follow-Up Tetralogy of Fallot Patients to Determine the Risk of Ventricular Arrhythmias

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