Reproducibility of the signal-averaged electrocardiogram

Engel, Toby R.; Pierce, Dan L.; Patil, Kashinath D.

doi:10.1016/0002-8703(91)90283-n

Cited by 28 publications

(10 citation statements)

References 15 publications

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“…8 The main limitation of the present study is that SAECG parameters can be affected by many factors not associated with antiarrhythmic therapy, such as transient ischemia, changes in autonomic tone, and conduction disturbances. 9,10 However, we conclude that changes in the serum concentration of flecainide, pilsicainide and pirmenol can be estimated from changes in the duration of f-QRS, which is prolonged in a dose-dependent manner, during SAECG recording. Such a screening test could improve the therapeutic monitoring of these antiarrhythmic agents by reducing the frequency of serum drug assays.…”

Section: Discussionmentioning

confidence: 78%

Therapeutic Monitoring of Class I Antiarrhythmic Agents Using High-Resolution Electrocardiography Instead of Blood Samples.

Sutovsky

Katoh

Takayama

et al. 2003

Circ J

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patient's optimal dose of oral medication for longterm antiarrhythmic treatment must be determined by therapeutic monitoring, usually frequent measurements of serum drug concentration; however, such measurements are costly and time-consuming. In previous studies, clinical administration of antiarrhythmic agents was found to cause changes in signal-averaged electrocardiographic (SAECG) parameters 1 and each antiarrhythmic agent affected the electrocardiographic (ECG) variables in a different manner. 2,3 Also, it has been reported that SAECG is more sensitive than a standard ECG in detecting the changes in QRS duration resulting from administration of class I antiarrhythmic drugs. 4,11 Therefore, the purposes of the present study were to compare the ECG changes caused by administration of 3 class I antiarrhythmic agents (flecainide, pilsicainide and, pirmenol), and to identify the SAECG parameters that might be used to estimate changes in serum concentration of antiarrhythmic agents during monitoring for long-term therapy. Methods PatientsWe enrolled 36 patients (12 taking flecainide; 12 pilsi-

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Section: Discussionmentioning

confidence: 78%

Therapeutic Monitoring of Class I Antiarrhythmic Agents Using High-Resolution Electrocardiography Instead of Blood Samples.

Sutovsky

Katoh

Takayama

et al. 2003

Circ J

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“…Although the effects of the magnitude of residual noise on QRSd have been well studied, several investigators have reported variability that is independent of absolute noise level. 2,7,8 Engel et al 8 studied immediate SAECG reproducibility in 18 normal subjects. Although they noted that the percent difference in paired measurements was normally distributed (actual data not shown), they concluded that "noise did not influence the variation in measurements in the time domain in a systematic way."…”

Section: Discussionmentioning

confidence: 99%

“…7,8,12,13 With late potentials, the phase relationship of noise to the lowamplitude signal has more dramatic effects on determination of QRS offset, accounting for the diminished reproducibility. This was nicely demonstrated by the wider distribution for S 1 in the computer simulation.…”

Section: Discussionmentioning

confidence: 99%

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Uncertainty Principle of Signal-Averaged Electrocardiography

Goldberger¹,

Challapalli²,

Waligora³

et al. 2000

Circulation

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“…Initial studies used the time-domain analysis exclusively [10,11] . While this is still the most frequently used technique, and has proven highly reproducible [12][13][14] , it nonetheless suffers from significant shortcomings: high-pass filters are required, discrimination between noise and late potentials may be difficult, and its results in patients with bundle branch block are uncertain [15][16][17] . To overcome these limitations, several frequency-domain techniques have been developed in recent years [18][19][20][21][22][23][24] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the new acceleration spectrum analysis with other time- and frequency-domain analyses of the signal-averaged electrocardiogram

Vázquez¹

1998

European Heart Journal

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Aim To compare four analysis techniques of the signalaveraged-electrocardiogram, including time-domain, spectral temporal mapping, spectral turbulence analysis and the new acceleration spectrum analysis. Methods and ResultsWe studied 634 subjects (77 with bundle branch block) divided into three groups. Group 1 comprised 117 post-myocardial infarction patients tested for inducibility of sustained ventricular tachycardia, and which was induced in 54 of them. Group 2 comprised 407 consecutive acute myocardial infarction survivors, followed for 1 year; 29 of them had suffered major arrhythmic events: 15 were cases of sustained ventricular tachycardia, three resuscitated ventricular fibrillation and 11 sudden cardiac death. Group 3 comprised 110 control subjects. The different analysis techniques were compared by their likelihood ratio for the prediction of ventricular tachycardia inducibility (Group 1) or major arrhythmic events (Group 2). The likelihood ratios of spectral-turbulence-analysis, acceleration spectrum analysis, spectral temporal mapping and time-domain were 8·0, 3·3, 1·7, 1·3 in Group 1, and 3·8, 2·1, 1·5, 2·6, in Group 2, while the corresponding falsepositive rates in Group 3 (control) were 0·9%, 10·0%, 4·5%, and 3·6%, respectively. ConclusionSpectral turbulence analysis was the most accurate technique for the prediction of either ventricular tachycardia inducibility or major arrhythmic events after myocardial infarction. It also showed the highest specificity among control subjects.

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Reproducibility of the signal-averaged electrocardiogram

Cited by 28 publications

References 15 publications

Therapeutic Monitoring of Class I Antiarrhythmic Agents Using High-Resolution Electrocardiography Instead of Blood Samples.

Therapeutic Monitoring of Class I Antiarrhythmic Agents Using High-Resolution Electrocardiography Instead of Blood Samples.

Uncertainty Principle of Signal-Averaged Electrocardiography

Comparison of the new acceleration spectrum analysis with other time- and frequency-domain analyses of the signal-averaged electrocardiogram

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