Use of signal-averaged electrocardiography for predicting inducible sustained monomorphic ventricular tachycardia in patients with bundle branch block with and without a history of syncope.
The aim of this study was to examine the utility of signal-averaged electrocardiography in relation to inducible sustained monomorphic ventricular tachycardia in patients with bundle branch block. One hundred fourteen patients with bundle branch block underwent signal-averaged electrocardiography in the time domain and programmed ventricular stimulation. Sustained monomorphic ventricular tachycardia was induced in 17 patients. The mean values of the three signal-averaged electrocardiographic variables analyzed differed significantly between the inducible and the noninducible group. The filtered QRS duration showed the most prominent difference between the two groups, and a filtered QRS duration > or = 155 msec had a sensitivity of approximately 80%, a specificity of 60%, and a total predictive value of 65%. In the subgroup of patients with syncope, a combination of these criteria with a history of coronary artery disease had a sensitivity of 100% and a specificity of 90%.
Englund
A
A
Department of Cardiology, Karolinska Hospital, Stockholm, Sweden.
Rosenqvist
M
M
Bergfeldt
L
L
D000368:Aged; D002037:Bundle-Branch Block / Q000150:complications / Q000175:diagnosis*; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology; D017180:Tachycardia, Ventricular / Q000150:complications / Q000175:diagnosis*