Non-invasive detection of late potentials in man–a new marker for ventricular tachycardia*

Breithardt, Günter; Becker, Ruediger; Seipel, L; Abendroth, R.-R.; Ostermeyer, J.

doi:10.1093/oxfordjournals.eurheartj.a061158

Cited by 239 publications

(33 citation statements)

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“…14 Recording and interpretation of signal averaged ECGs were performed according to published criteria. 15 Drug challenge with procainamide and epinephrine was performed as previously described. 11,16 Cardiac abnormalities were defined as new diagnosis of a previously unknown primary electric disorder (eg, LQT syndrome or Brugada syndrome), a new diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC) or as new diagnosis of another previously unknown structural heart disease (eg, hypertrophic cardiomyopathy, myocarditis, cardiac sarcoidosis, etc.).…”

Section: Cardiac Investigationsmentioning

confidence: 99%

Cardiac Abnormalities in First-Degree Relatives of Unexplained Cardiac Arrest Victims

Steinberg¹,

Padfield²,

Champagne³

et al. 2016

Circ: Arrhythmia and Electrophysiology

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Background— Unexplained cardiac arrest (UCA) may be explained by inherited arrhythmia syndromes. The Cardiac Arrest Survivors With Preserved Ejection Fraction Registry prospectively assessed first-degree relatives of UCA or sudden unexplained death victims to screen for cardiac abnormalities. Methods and Results— Around 398 first-degree family members (186 UCA, 212 sudden unexplained death victims’ relatives; mean age, 44±17 years) underwent extensive cardiac workup, including ECG, signal averaged ECG, exercise testing, cardiac imaging, Holter-monitoring, and selective provocative drug testing with epinephrine or procainamide. Genetic testing was performed when a mutation was identified in the UCA survivor or when the diagnostic workup revealed a phenotype suggestive of a specific inherited arrhythmia syndrome. The diagnostic strength was classified as definite, probable, or possible based on previously published definitions. Cardiac abnormalities were detected in 120 of 398 patients (30.2%) with 67 of 398 having a definite or probable diagnosis (17%), including Long-QT syndrome (13%), catecholaminergic polymorphic ventricular tachycardia (4%), arrhythmogenic right ventricular cardiomyopathy (4%), and Brugada syndrome (3%). The detection yield was similar for family members of UCA and sudden unexplained death victims (31% versus 27%; P =0.59). Genetic testing was performed more often in family members of UCA patients (29% versus 20%; P =0.03). Disease-causing mutations were identified in 20 of 398 relatives (5%). The most common pathogenic mutations were RyR2 (2%), SCN5A (1%), and KNCQ1 (0.8%). Conclusions— Cardiac screening revealed abnormalities in 30% of first-degree relatives of UCA or sudden unexplained death victims, with a clear working diagnosis in 17%. Long-QT, arrhythmogenic right ventricular cardiomyopathy, and catecholaminergic polymorphic ventricular tachycardia were the most common diagnoses. Systematic cascade screening and genetic testing in asymptomatic individuals will lead to preventive lifestyle and medical interventions with potential to prevent sudden cardiac death. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00292032.

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Section: Cardiac Investigationsmentioning

confidence: 99%

Cardiac Abnormalities in First-Degree Relatives of Unexplained Cardiac Arrest Victims

Steinberg¹,

Padfield²,

Champagne³

et al. 2016

Circ: Arrhythmia and Electrophysiology

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“…Previous clinical studies have dealt with patients with cardiac disease either with or without VT, and only limited data are available in normal subjects. 13,14 The purposes of this study were to provide a quantitative analysis of the high-frequency components of the terminal portion of the signal-averaged surface QRS in normal subjects, to test the reproducibility of this analysis, to provide a quantitative analysis of the high-frequency components of the terminal portion of the signal-averaged surface QRS in patients with VT, and to compare the findings of normal subjects with those of patients with VT.…”

mentioning

confidence: 99%

Quantitative analysis of the high-frequency components of the terminal portion of the body surface QRS in normal subjects and in patients with ventricular tachycardia.

et al. 1983

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SUMMARY Quantitative analysis of the high-frequency components of the terminal portion of the surface QRS was performed in 42 normal subjects (group 1, ages 18-67 years, mean + SEM 34.7 + 2.2 years) and in 12 patients with symptomatic, sustained ventricular tachycardia (VT) (group 2, ages 48-76 years, mean 59 + 2.3 years). Signal averaging and high-pass, bidirectional digital filtering were used for analysis. The total duration of the QRS, the duration of the low-amplitude signals (< 40

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“…The correlation between ventricular late potentials and sustained monomorphic ventricular tachycardia has been widely discussed in the literature [2][3]13,18 . One week after transmural myocardial infarction, approximately 30% to 60% of patients have ventricular late potentials on signal-averaged electrocardiography.…”

Section: Discussionmentioning

confidence: 99%

“…Ventricular late potentials are markers of reentry ventricular arrhythmias [1][2][3] . Due to the low velocity of conduction, these potentials exceed the duration of ventricular activation and are detected in the ST-segment.…”

Section: Analysis Of the Prevalence Of Ventricular Late Potentials Inmentioning

confidence: 99%

Analysis of the Prevalence of Ventricular Late Potentials in the Late Phase of Myocardial Infarction Based on the Site of Infarction

Paulo

Benchimol-Barbosa

Sousa

et al. 2002

Arq. Bras. Cardiol.

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Objective -The initial site of myocardial infarction (MI) may influence the prevalence of ventricular late potentials (VLP), high-frequency signals, due to the time course of ventricular activation. The prevalence of VLP in a period of more than 2 years after acute MI was assessed focusing on the initially injured wall . Methods - [1][2][3] . Due to the low velocity of conduction, these potentials exceed the duration of ventricular activation and are detected in the ST-segment. The use of statistical techniques, in which 2 to 3 hundred sequential QRS complexes detected on the body surface are independently coherent-averaged, allows amplification and identification of these signals because of the reduction in the intensity of the instrumentation noises 4-7 .The identification of ventricular late potentials in patients with a transmural myocardial infarction is of major interest 3,[8][9][10] . The myocardial remodeling process that follows transmural myocardial infarction is characterized by fibrosis, redistribution of fibers in the injured region, and residual metabolic alterations not only plays a major role in segmentary myocardial function but also provides a favorable environment for the development of reentry circuits 11 .Considering these markers, preliminary studies suggest that transmural myocardial infarctions involving the inferiorinferodorsal wall have a higher prevalence of ventricular late potentials than those involving the anterior-anteroseptal wall. These findings are based on differences related to the start of electrical activation in the affected regions 12,13 . However, studies relating the prevalence of ventricular late potentials after transmural myocardial infarction with the affected wall show some conflicting results. Some studies have focused attention on the occurrence of ventricular late potentials in the first 12 months after transmural myocardial infarction when the myocardial remodeling process is still underway 14 . Data on the prevalence of ventricular late potentials in a late phase (>2 years) of transmural myocardial infarction are very scarce. In this phase, the prevalence of ventricular late potentials reflects not only the natural

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Non-invasive detection of late potentials in man–a new marker for ventricular tachycardia*

Cited by 239 publications

References 0 publications

Cardiac Abnormalities in First-Degree Relatives of Unexplained Cardiac Arrest Victims

Cardiac Abnormalities in First-Degree Relatives of Unexplained Cardiac Arrest Victims

Quantitative analysis of the high-frequency components of the terminal portion of the body surface QRS in normal subjects and in patients with ventricular tachycardia.

Analysis of the Prevalence of Ventricular Late Potentials in the Late Phase of Myocardial Infarction Based on the Site of Infarction

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