Spectral turbulence analysis of the signal-averaged electrocardiogram and its predictive accuracy for inducible sustained monomorphic ventricular tachycardia

Kelen, George; Henkin, Raphael; Starr, Ann-Marie; Caref, Edward B.; Bloomfield, Dennis A.; El‐Sherif, Nabil

doi:10.1016/0002-9149(91)90169-l

Cited by 149 publications

(54 citation statements)

References 24 publications

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“…l 2 In patients with ischemic heart disease, it has been suggested that >95% of these signals occur before the terminal QRS starts and are not detected by time domain anal~sis.2~ Patients with dilated cardiomyopathy have widespread endomyocardial damage and greater prolongation of their QRS complex than patients with old myocardial infarction, and it is likely that this is of at least equal importance in this condition.I2 Spectral turbulence analysis of the SAECG is fundamentally different from time domain analysis in that it examines frequent and abrupt changes in the frequency signature of the QRS wave front velocity as it propagates through the ventricle around areas of abnormal conduction24. 25 and thereby detects abnormal signals anywhere within the QRS complex. It is applicable to patients with or without left bundle-branch block and is therefore appropriate in patients with dilated cardiomyopathy.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of time domain and spectral turbulence analysis of the signal‐averaged electrocardiogram for the prediction of prognosis in idiopathic dilated cardiomyopathy

Yan¹,

Keeling²,

Goldman³

et al. 1996

Clinical Cardiology

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SummaryBackground: Despite significant advances in the treatment of heart failure, the prognosis of patients with idiopathic dilated cardiomyopathy remains poor. Although several of prognostic vaiables have been shown to be useful in risk stratification of patients with idiopathic dilated cardiomyopathy, their predictive accuracy is low and clinical usefulness uncertain.Hypothesis: This study was undertaken to assess the signalaveraged electrocardiogram (SAECG) in patients with idiopathic dilated cardiomyopathy and to compare the ability of time domain and spectral turbulence analytic techniques to predict clinical outcome.Methods: SAECG analysis was performed in 80 patients with idiopathic dilated cardiomyopathy. Nineteen patients had left bundle-branch block and eight were taking low-dose amiodarone for life-threatening arrhythmias. Conventional time domain and spectral turbulence analyses of the SAECG were perfonned using Del Mar 183 software.Results: During a follow-up of 27 f 19 months, 24 patients developed progressive heart failure, while the others remained clinically stable. Late potentials were detected in 28%

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Section: Discussionmentioning

confidence: 99%

“…Many 25 have shown that the presence of late potentials or abnormalities of spectral turbulence analysis of the SAECG identifies patients at increased risk of ventricular arrhythrmas and sudden death following acute myocardial infarction. This association was not observed in this study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of time domain and spectral turbulence analysis of the signal‐averaged electrocardiogram for the prediction of prognosis in idiopathic dilated cardiomyopathy

Yan¹,

Keeling²,

Goldman³

et al. 1996

Clinical Cardiology

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“…In 1991, Kelen et al 11 proposed a new model to compensate for some disadvantages of the time-domain analysis and the methods used until then for frequency-domain analysis 12 . This technique includes the analysis of the QRS complex as a whole and not only the previously determined temporal part of frequency or amplitude.…”

Section: Discussionmentioning

confidence: 99%

Atrial activation during sinus rhythm in patients with rheumatic and non-rheumatic paroxysmal atrial fibrillation. Frequency-domain analysis using signal-averaged electrocardiography

Dantas¹,

Barbosa²,

Benchimol-Barbosa³

et al. 2001

Arq. Bras. Cardiol.

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Objective -Using P-wave signal-averaged electrocardiography, we assessed the patterns of atrial electrical activation in patients with idiopathic atrial fibrillation as compared with patterns in patients with atrial fibrillation associated with structural heart disease. Atrial fibrillation is the most common sustained arrhythmia diagnosed in clinical practice [1][2][3][4] . In the general population, its prevalence increases with age: it is lower than 1% in the age bracket from 40 to 65 years, ranges from 2% to 5% in the age bracket from 65 to 74 years, and is higher than 5% above the age of 75 years. No difference in incidence has been observed between the sexes 1 . The increase in prevalence and incidence of atrial fibrillation with age is mainly associated with coexisting cardiac diseases. However, an independent effect of direct ageing on the atrial tissue cannot be excluded 5 . Methods -Eighty patients with recurrent paroxysmalA history of congestive heart failure, rheumatic valvar disease, left ventricular hypertrophy, and left atrial enlargement are independent risk factors associated with the genesis of atrial fibrillation. The presence of this arrhythmia in structurally normal hearts, although infrequent, may be detected in clinical practice. The triggering and maintenance factors of idiopathic atrial fibrillation are not very well defined. However, a significant number of patients with the paroxysmal or persistent form of atrial fibrillation, even though without evidence of anatomical cardiac alterations, evolve towards chronic atrial fibrillation. Such patients include those with structural heart disease despite the use of antiarrhythmic drugs. The objective of our study was to identify the electrophysiological behavior of atrial activation in patients with paroxysmal or persistent atrial fibrillation, through the use of P-wave signal-averaged electrocardiography for frequency-domain analysis. MethodsIn a cross-sectional study, we analyzed 80 patients who were being followed up in the outpatient cardiac arrhythmia care unit of the Hospital Universitário Pedro Ernesto. These patients had a history of at least 2 episodes of paroxysmal or persistent atrial fibrillation confirmed on electrocardiography in the last year, and they had not used any antiarrhythmic drug for at least 5 half-lives of each drug in

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“…9 However, they are localized and so small that we cannot detect them on the standard extracorporeal 12-lead ECG. Several approaches, such as spectro-temporal mapping, 19 spectral-turbulance analysis, 20 and heart rate variability 21,22 has been made to record them by surface ECG, but their utility is still uncertain.…”

Section: Validity Of Ecg Analysis Using Wavelet Transformmentioning

confidence: 99%

Evaluation of Arrhythmogenic Substrate in Patients With Hypertrophic Cardiomyopathy Using Wavelet Transform Analysis

Takayama

Yodogawa

Katoh

et al. 2006

Circ J

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Spectral turbulence analysis of the signal-averaged electrocardiogram and its predictive accuracy for inducible sustained monomorphic ventricular tachycardia

Cited by 149 publications

References 24 publications

Comparison of time domain and spectral turbulence analysis of the signal‐averaged electrocardiogram for the prediction of prognosis in idiopathic dilated cardiomyopathy

Comparison of time domain and spectral turbulence analysis of the signal‐averaged electrocardiogram for the prediction of prognosis in idiopathic dilated cardiomyopathy

Atrial activation during sinus rhythm in patients with rheumatic and non-rheumatic paroxysmal atrial fibrillation. Frequency-domain analysis using signal-averaged electrocardiography

Evaluation of Arrhythmogenic Substrate in Patients With Hypertrophic Cardiomyopathy Using Wavelet Transform Analysis

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