title: Prediction of arrhythmic events after acute myocardial infarction using two methods for late potentials recording.
abstract: One hundred consecutive patients recovering from an acute myocardial infarction underwent, prior to home discharge, signal-averaged electrocardiography (ECG), left ventriculography, and 24-hour Holter ECG recording. The signal-averaged ECG was recorded and analyzed using two procedures: the orthogonal bipolar XYZ lead configuration with a bidirectional filter; and a precordial unipolar lead configuration with a nonrecursive digital filter. An abnormal signal-averaged ECG was seen in 40% of patients with the XYZ system and in 30% of patients in the precordial method, abnormal ejection fraction (< 40%) in 24% of patients and high grade ectopy activity in 22%. During the 24-month follow-up period, 12 patients (12%) had an arrhythmic event defined as either sudden death (11 patients) or sustained ventricular tachycardia (1 patient). Neither the signal-averaged ECG with the XYZ configuration, the abnormal ejection fraction, nor the high grade ectopy were able to statistically predict a higher arrhythmic event rate. The signal-averaged ECG with the precordial configuration was able to statistically predict a higher arrhythmic event rate, P < 0.03; odds ratio = 3.96. The combination of the orthogonal XYZ configuration signal-averaged ECG with the ejection fraction (P < 0.01, odds ratio = 7.33), or with ejection fraction and Holter monitoring (P < 0.06, odds ratio = 6.17) was able to predict a higher arrhythmic event rate. The combination of the precordial configuration signal-averaged ECG with the ejection fraction (P < 0.002, odds ratio = 14.4), or with ejection fraction and Holter monitoring (P < 0.06, odds ratio = 10) was able to better predict a higher arrhythmic event rate.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Cardiology Department, Beilinson Medical Center, Petah Tiqva, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Strasberg
authors.forename: S
authors.initials: S
authors.lastname: Abboud
authors.forename: J
authors.initials: J
authors.lastname: Kusniec
authors.forename: S
authors.initials: S
authors.lastname: Inbar
authors.forename: N
authors.initials: N
authors.lastname: Zafrir
authors.forename: A
authors.initials: A
authors.lastname: Mager
authors.forename: A
authors.initials: A
authors.lastname: Sagie
authors.forename: S
authors.initials: S
authors.lastname: Sclarovsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis*; D004562:Electrocardiography / Q000379:methods; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D015635:Radionuclide Ventriculography; D012680:Sensitivity and Specificity; D013318:Stroke Volume