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High-frequency powers hidden within QRS complex as an additional predictor of lethal ventricular arrhythmias to ventricular late potential in post-myocardial infarction patients.

Abstract：

BACKGROUND:Ventricular late potentials (VLPs) have been known to be a predictor of lethal ventricular arrhythmias (L-VAs); however, detection of other arrhythmogenic signals within the QRS complex remains obscure. OBJECTIVE:The aim of this study was to evaluate whether abnormal intra-QRS high-frequency powers (IQHFP) within the QRS complex become a new predictor of L-VAs in addition to VLPs. METHODS:Both 12-lead electrocardiograms (ECG) and VLPs were recorded from 142 subjects, including 37 patients without heart diseases, 97 patients post-myocardial infarction (MI), and 45 post-MI patients with L-VAs. Time-frequency analysis of ECG (leads V(1) or II) using wavelet transform with the Morlet function was performed. After the time-frequency powers were calculated, the ratios of the peak of signal power during the QRS complex in high-frequency bands against the peak power at 80 Hz (b/a ratio; P100, P150, P200, P250, or P300Hz/P80Hz) were measured. Abnormal IQHFP was defined when the b/a ratio exceeded the optimal cut-off values estimated by receiver-operator characteristic curves. RESULTS:The combination of abnormal IQHFP appearing at 200, 250, and 300 Hz with positive VLPs increased the sensitivity for prediction of L-VAs from 53.3% by VLPs to 89.5%, and the negative predictive value from 74.7% by VLPs to 87.7%. CONCLUSION:The combined use of VLPs and IQHFP hidden within the QRS complex improved the prediction of L-VAs in post-MI patients.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Tsutsumi T,Takano N,Matsuyama N,Higashi Y,Iwasawa K,Nakajima T

doi

10.1016/j.hrthm.2011.06.027

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

1509-15

issue

10

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(11)00782-X

journal_volume

8

pub_type

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