[The clinical significance of signal-averaged electrocardiography in hypertrophic cardiomyopathy].
We examined 44 patients (pts) with hypertrophic cardiomyopathy to evaluate the prognostic value of signal-averaged electrocardiography and its possible correlations with clinical and instrumental data. All pts (31 male, 13 female, mean age 47 +/- 15) underwent clinical examination, standard electrocardiography, M-mode and two-dimensional echocardiography, 24-72 hour dynamic electrocardiography and signal-averaged electrocardiography. The mean follow-up was 14 +/- 4 months. Signal-averaged electrocardiography was performed using a 40-250 Hz bidirectional filter. An abnormal signal-averaged electrocardiography with late potentials (filtered QRS duration greater than or equal to 120 msec and root mean square voltage in terminal 40 msec less than or equal to 20 microvolts) was detected in 5 pts (group A, 11%) while 39 pts (group B, 89%) had a normal signal-averaged electrocardiography. Ventricular tachycardia runs at dynamic ECG were present in 2 pts in group A (40%), and in 8 in group B (21%, p = NS). No statistical differences were found between the two groups for any clinical or instrumental data. During our study, one group A patient died suddenly. In detecting subjects with ventricular tachycardia runs, signal-averaged electrocardiography sensitivity was 20%, and specificity was 91%. High specificity suggests that signal-averaged electrocardiography might be used to detect pts at a lower risk for ventricular tachycardia. Further investigations are required to evaluate the predictive value of signal-averaged electrocardiography for sudden death in hypertrophic cardiomyopathy.
Campana
M
M
Divisione di Cardiologia, Ospedali Riuniti di Parma.
Rolli
A
A
Maffei
M L
ML
Callerame
M
M
Lazzeroni
E
E
Botti
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000503:physiopathology*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies
Significato clinico dell'elettrocardiogramma mediato di superficie nella cardiomiopatia ipertrofica.