Phase and group-delay characteristics of signal-averaged electrocardiograms from patients with ventricular tachycardia.
Fourier analysis of the signal-averaged ECG (SAECG) has previously revealed significant differences in magnitude spectra that differentiate patients with ventricular tachycardia (VT) from those without VT. To determine additional distinguishing features in the frequency domain, we analyzed phase spectra of SAECG's of sinus beats from 57 patients with VT, 65 without VT, and 20 normal controls. Unwrapped phase spectra from SAECG's of the entire cardiac cycle were calculated with respect to three fiducial points: onset of the P and Q waves, and the negative of the slope of the phase (group delay) for frequencies in the band, which accounted for 97.5% of the energy in the vector magnitude of the Frank SAECG leads. Phase spectra of SAECG's from patients with VT differed from the non-VT patients at frequencies > or = 21 Hz (p = 0.000039) for the P-wave fiducial, at frequencies > or = 60 Hz (p = 0.00085) for the Q-wave fiducial, and at frequencies < or = 62 Hz (p = 0.0035) for the 97.5% energy fiducial. Group delays in SAECG's from patients with and without VT differed from 10 to 26 Hz (p = 0.000016) for the P-wave fiducial, and from 14 to 24 Hz (p = 0.00000070) for the Q-wave fiducial. Group delays with respect to the Q-wave fiducial in the VT patients in the 14-24 Hz band were, on average, 9 ms and 5 ms longer than those of the non-VT's and normals, respectively. Thus, phase spectra of SAECG's contain previously undetected features that together with magnitude may be helpful in improving methods for stratifying the risk of VT.
Arthur
R M
RM
Department of Electrical Engineering, Washington University, St. Louis, MO 63130.
Kavesh
N G
NG
Ambos
H D
HD
Cain
M E
ME
D004562:Electrocardiography / Q000379:methods; D005583:Fourier Analysis; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications; D011446:Prospective Studies; D012815:Signal Processing, Computer-Assisted; D013318:Stroke Volume; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology