title: Sudden cardiac death after coronary artery bypass grafting is not predicted by signal-averaged ECG.
abstract: BACKGROUND
  Sudden cardiac death (SCD) is a major cause of death despite successful revascularization in patients with coronary artery disease. The signal-averaged ECG (SAECG) is a sensitive predictor of SCD and could be used in the screening strategy to select patients for prophylactic cardioverter implantation.
  
  
  METHODS
  The SAECG was recorded in 561 patients (mean age: 60 +/- 8.8 years) within 10 days of coronary artery bypass grafting. Signal-averaged ECG was performed with a bandpass filtering of 40 to 250 Hz for more than 250 beats until a noise level of 0.6 microV was achieved. All patients were followed for 5.5 +/- 1.2 years after the procedure.
  
  
  RESULTS
  Preoperative angiographic ejection fraction was at least 60% in 393 patients (72%), 40% to 60% in 126 patients (23%), and 40% or less in 28 patients (5%). There were 34 deaths, 10 of which were SCD. Late potentials were found in a total of 150 patients (27%) and were equally frequent preoperatively and postoperatively and among patients with (30%) and without (27%) SCD. The only predictors for overall mortality were age and a reduced ejection fraction.
  
  
  CONCLUSIONS
  Signal-averaged ECG did not predict prognosis in low-risk patients undergoing coronary artery bypass grafting.
authors.affiliation: Division of Cardiology, University Hospital, Zurich, Switzerland. christoph.scharf@dim.usz.ch
authors.forename: C
authors.initials: C
authors.lastname: Scharf
authors.forename: H
authors.initials: H
authors.lastname: Redecker
authors.forename: F
authors.initials: F
authors.lastname: Duru
authors.forename: R
authors.initials: R
authors.lastname: Candinas
authors.forename: H P
authors.initials: HP
authors.lastname: Brunner-La Rocca
authors.forename: A
authors.initials: A
authors.lastname: Gerber
authors.forename: O
authors.initials: O
authors.lastname: Bertel
authors.forename: M I
authors.initials: MI
authors.lastname: Turina
authors.forename: W
authors.initials: W
authors.lastname: Kiowski
mesh_terms: D001026:Coronary Artery Bypass / Q000009:adverse effects*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D013997:Time Factors