title: Prevalence of late potentials on signal-averaged ECG in patients with psychiatric disorders.
abstract: BACKGROUND
  Sudden cardiac death (SCD) occurs three times more often in psychiatric patients than in the general population. QRS fragmentation (QRSfr) and signal-averaged electrocardiography (SAECG) are simple, inexpensive, readily available tools for detecting the presence of abnormal depolarization and late potentials (LPs) in these patients, a result of either the underlying disease or treatment.
  
  
  METHODS
  Frequency of LP detection by SAECG and QRSfr was studied in 52 psychiatric patients and compared with 30 healthy (without known structural heart disease or occurrence of ventricular arrhythmia) controls. Patients were then prospectively followed up and incidence of SCD was recorded.
  
  
  RESULTS
  LP prevalence was significantly higher in patients than in controls (16/52-31% vs 2/30-7%, p=0.012), while QRSfr was similar between these two groups (p=0.09). Of the LP presence criteria, the root mean square value at terminal 40msec of the QRS (RMS40) was significantly lower in patients (32μV, SD=19μV, vs 46μV, SD=32μV, p=0.015). Among patients, no differences were noted between the LP positive and negative groups regarding age, sex, number of medications, class of antipsychotics and defined daily doses. Mean follow-up was 46months (SD=11) and during it 3 patients suffered SCD. Although 2 SCD victims had both LPs and QRSfr concurrently present, neither of them, nor their simultaneous presence could definitely account for the events.
  
  
  CONCLUSIONS
  LP prevalence in psychiatric patients was significantly higher than in controls. SAECG performance was feasible in all cases and constitutes a readily available tool for assessing myocardial electrophysiological alterations in this patient group.
authors: First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors: Christos-Konstantinos
authors: CK
authors: Antoniou
authors: First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors: Ippokratis
authors: I
authors: Bournellis
authors: "Agia Irini" Psychiatric Hospital, Drama, Greece.
authors: Achilleas
authors: A
authors: Papadopoulos
authors: First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors: Dimitris
authors: D
authors: Tsiachris
authors: First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors: Petros
authors: P
authors: Arsenos
authors: First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors: Polychronis
authors: P
authors: Dilaveris
authors: Third Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors: Ioannis
authors: I
authors: Diakogiannis
authors: State Department of Cardiology, Hippokration General Hospital, Athens, Greece.
authors: Skevos
authors: S
authors: Sideris
authors: State Department of Cardiology, Hippokration General Hospital, Athens, Greece.
authors: Ioannis
authors: I
authors: Kallikazaros
authors: First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: kgatzoul@med.uoa.gr.
authors: Konstantinos A
authors: KA
authors: Gatzoulis
authors: First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors: Dimitrios
authors: D
authors: Tousoulis
mesh_terms: D000368:Aged; D004562:Electrocardiography / Q000523:psychology* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence
keywords: Depression; Risk stratification; Schizophrenia; Signal-averaged ECG; Sudden cardiac death