High frequency intra-QRS signals in idiopathic dilated cardiomyopathy.
We extracted and quantified high frequency intra-QRS signals in idiopathic dilated cardiomyopathy (IDC). In IDC the analysis of late potentials in the terminal QRS complex often fails in predicting clinical events because of intraventricular conduction abnormalities and the absence of a circumscribed arrhythmogenic substrate. Therefore, new approaches are required to assess the electrical state of the myocardium. We investigated 21 patients suffering from IDC with (n = 14) and without (n = 7) bundle branch block. High resolution 31 lead magnetocardiograms were filtered with a 67 point 4th order Savitzky-Golay filter. The difference of the measured and filtered signals was calculated (67-200 Hz). The spatio-temporal properties and the areas under the curves of the resulting high frequency intra-QRS signals (IQCs) were studied. We detected IQCs in all patients. The patients had individual patterns regarding the temporal and spatial properties of the IQCs during depolarisation. The IQCs predominantly appeared in the initial portion of the QRS. The ratios of the areas under the curves of the IQCs and the measured signals were linearly correlated to the left ventricular enddiastolic diameter (r = 0.71, significance 0.0012). In IDC the ventricular depolarization is accompanied by individual spatial and temporal patterns of high frequency intra-QRS signals. They can be studied non-invasively from body surface mapping data with the algorithm used in this study. This provides access to the assessment of the electrical status in patients with IDC.
Leder
U
U
Klinik für Innere Medizin III, Klinikum der Universität Jena. uwe.leder@uni-jena.de
Haueisen
J
J
Liehr
M
M
Baier
V
V
Frankenstein
L
L
Nowak
H
H
Figulla
H R
HR
D000328:Adult; D000368:Aged; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000503:physiopathology*; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology*; D004562:Electrocardiography / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation