title: Beat-to-beat variations of the electrocardiogram in survivors of sudden death without structural heart disease.
abstract: OBJECTIVE
  We sought to determine whether survivors of sudden death without structural heart disease have beat-to-beat electrocardiographic (ECG) characteristics at the microvolt and at the millisecond level that differ from normal subjects.
  
  
  METHODS
  We studied patients at our implantable cardioverter defibrillator clinic who had been resuscitated from ventricular fibrillation with no evidence of underlying structural heart disease. Continuous 10-minute high-resolution unfiltered digital surface ECGs at 1000-Hz sampling rate were acquired in these subjects and in a group of healthy volunteers. We then analyzed different parameters of beat-to-beat variations in duration, amplitudes and vectors of the QRS complex, and the T wave using a locally developed program (Comparative Analysis of ECGs, Vectocardiograms, and their Interpretation with Auto-Reference to the patient) and compared them between the 2 groups.
  
  
  RESULTS
  Thirteen patients (7 men; age, 46 +/- 16 years) were studied. Standard ECGs were unremarkable in 7 patients and suggestive of Brugada syndrome in the 6 others. The control group consisted of 23 age- and sex-matched subjects (13 men; age, 41 +/- 10 years). Although the QRS parameters showed only few differences between the 2 groups, there were several differences in parameters evaluating repolarization.
  
  
  CONCLUSIONS
  High-resolution ECGs show distinct beat-to-beat variations in parameters of repolarization in survivors of sudden death without structural heart disease, as compared with normal subjects. These findings may reflect increased electrical instability and should be evaluated for stratifying arrhythmic risk in asymptomatic individuals.
authors.affiliation: Unité 50, Hôpital Louis-Pradel, Lyon, France. haran.burri@hcuge.ch
authors.forename: Haran
authors.initials: H
authors.lastname: Burri
authors.forename: Philippe
authors.initials: P
authors.lastname: Chevalier
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Fayn
authors.forename: Marie-Claire
authors.initials: MC
authors.lastname: Forlini
authors.forename: Paul
authors.initials: P
authors.lastname: Rubel
authors.forename: Paul
authors.initials: P
authors.lastname: Touboul
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation; D017741:Survivors