Role of bandpass filters in optimizing the value of the signal-averaged electrocardiogram as a predictor of the results of programmed stimulation

Caref, Edward B.; Turitto, Gioia; Ibrahim, Bassiema; Henkin, Raphael; El‐Sherif, Nabil

doi:10.1016/0002-9149(89)90646-2

Cited by 86 publications

(19 citation statements)

References 12 publications

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“…Previous reports suggest that the diagnostic criteria between normal and abnormal SAE values and the late potentials of QRS vary, depending on the equipment used and how the filters are set. However, according to these reports, values determined from a 95% confidence interval of normal subjects [3][4][5][6][7] or determined standard values for comparison of myocardial infarction patients with and without ventricular tachycardia [8][9][10] those criteria varied. The difference in RMS 20 caused by (F) and (B) filter direction was also observed in our study.…”

Section: Discussionmentioning

confidence: 99%

Age and Sex Differences in the P-Wave Signal-Averaged Electrocardiogram in a Japanese Study Population.

et al. 2001

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SUMMARYNormal P wave signal-averaged electrocardiogram (SAE) values were determined in 120 healthy Japanese adults (56 men, 64 women), aged 44.5±10.2 years (mean±SD). The P wave trigger method was used with a Fukuda FDX6500 recorder. We used bipolar Weak positive correlations were observed between fPd (F) and body surface area, fPd (F) and age, fPd (B) and body surface area, fPd (B) and age, fPd (C) and body surface area, and fPd (C) and age. There was no evident correlation, however, between either forward or backward RMS 20 and body surface area or between forward or backward RMS 20 and age. Differences in the normal P wave values between the sexes and age groups were evaluated in this study. (Jpn Heart J 2001; 42: 295-305) Key words: Signal-averaged P wave electrocardiogram, Japanese, Sex, Age ATRIAL late potential studies of P wave recordings by signal-averaged electrocardiography (SAE) have recognized the utility for identifying patients at risk for paroxysmal atrial fibrillation (Paf) during sinus rhythm.1,2) With Paf, filtered P duration (fPd) is long, the last 20-ms root mean square voltage (RMS 20 ) is reported to be low, and the occurrence of Paf can be predicted by such values during sinus rhythm. However, there have been no reports of normal P wave SAE values in Japan.We conducted a study in healthy Japanese subjects to determine the normal value of P waves SAE and to investigate age and sex differences. We expected a From the

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Section: Discussionmentioning

confidence: 99%

Age and Sex Differences in the P-Wave Signal-Averaged Electrocardiogram in a Japanese Study Population.

et al. 2001

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“…Ventricular late potentials have been analyzed in several frequency bands aiming not only to identify the frequency content of these signals, but also to investigate the region of the frequency spectrum that allows its identification with a higher diagnostic efficiency 19,20 . This type of investigation is mainly justified from the viewpoint of electrocardiographic signal processing, because high-pass cut-off filters with lower cut-off frequencies (25Hz) preserve the high-energy QRS characteristics, while higher cut-off frequencies (80Hz) remove the high energies and preserve high frequency signals originating in small groups of myocardial fibers in regions of slow and fragmented conduction.…”

Section: Discussionmentioning

confidence: 99%

“…The variable RMS40 was transformed into a natural logarithm (Lnt) prior to analysis, due to its asymmetric probability distribution 20 . This procedure not only statistically normalizes the distribution, but also reduces data variability, concentrating them around the mean.…”

Section: Methodsmentioning

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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“…30 Three parameters were examined at 25 and 40 Hz high-pass filter settings; 31 QRS duration (QRSd), that is the duration of the filtered QRS; root-mean-square voltage of the terminal 40 msec (RMS 40 ) of the filtered QRS; and low-amplitude signal duration (LASd), that is the duration of low amplitude signals measured from the filtered QRS offset backward to when the signal reaches the voltage of 40 V. According to normal values in our laboratory, late potentials were considered to be present if at least one of the above mentioned parameters was abnormal at both 25 and 40 Hz filter settings (QRSd Ͼ109 and 106 msec, RMS 40 , Ͻ28 and 16 V and LASd Ͼ29 and 40 msec, respectively).…”

Section: Protocol Of the Studymentioning

confidence: 99%

“…The greater impairment in sympatho-vagal balance observed in hypertensive patients with concentric LVH may contribute to explain why this subgroup experiences the highest incidence of cardiovascular events. 16,31,55 Therefore, in hypertensive heart disease the kind of left ventricular remodeling, more than the increased ventricular mass, seems to be an important factor in influencing the autonomic modulation of the heart. Ventricular late potentials, used in an attempt to unmask patients at higher risk of ventricular arrhythmias, were found in a small number of patients, and no significant differences were observed either between patients with and without LVH or between patients with concentric and eccentric LVH, confirming previous data from our laboratory.…”

Section: Allmentioning

confidence: 99%

Cardiac autonomic modulation and incidence of late potentials in essential hypertension: role of age, sex, ventricular mass and remodeling

et al. 1998

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Role of bandpass filters in optimizing the value of the signal-averaged electrocardiogram as a predictor of the results of programmed stimulation

Cited by 86 publications

References 12 publications

Age and Sex Differences in the P-Wave Signal-Averaged Electrocardiogram in a Japanese Study Population.

Age and Sex Differences in the P-Wave Signal-Averaged Electrocardiogram in a Japanese Study Population.

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

Cardiac autonomic modulation and incidence of late potentials in essential hypertension: role of age, sex, ventricular mass and remodeling

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