Noninvasive beat-by-beat registration of ventricular late potentials using high resolution electrocardiography.

We have developed a new high resolution ECG equipment for recording cardiac microvolt potentials from the body surface. Noise reduction has been achieved by specially designed suction electrodes, by spatial averaging of the electrocardiograms from four electrode pairs, using extremely low noise amplifiers, by performing registrations within a Faraday cage, and by teaching the patient to relax during end expiratory breath holding. Fourteen young males (controls) and 30 patients with various cardiac diseases (27 with CHD) were studied. In normals ventricular late potentials were not seen, but in 12/30 patients clearcut diastolic potentials were found. In 7/12 patients with positive findings, late potentials appeared beat-by-beat, in 5/12 patients those signals occurred intermittently, in 11/30 patients questionably, and in the remaining 5/30 patients no late potentials were recorded. One patient with the Romano-Ward syndrome revealed phases with stable beat-by-beat and intermittently occurring ventricular late potentials. These results demonstrate the feasibility of continuous non-invasive recording of ventricular late potentials, whose clinical and prognostic significance remains to be established.

[1]  R Lazzara,et al.  Re‐entrant Ventricular Arrhythmias in the Late Myocardial Infarction Period: 2. Patterns of Initiation and Termination of Re‐entry , 1977, Circulation.

[2]  R Lazzara,et al.  Re‐entrant Ventricular Arrhythmias in the Late Myocardial Infarction Period: 1. Conduction Characteristics in the Infarction Zone , 1977, Circulation.

[3]  L. Horowitz,et al.  Continuous Local Electrical Activity: A Mechanism of Recurrent Ventricular Tachycardia , 1978, Circulation.

[4]  P M Rautaharju,et al.  Measurement and characteristics of over-all noise content in exercise electrocardiograms. , 1967, American heart journal.

[5]  J A Gomes,et al.  Appraisal of a Low Noise Electrocardiogram. , 1983, Journal of the American College of Cardiology.

[6]  J. Boineau,et al.  Slow Ventricular Activation in Acute Myocardial Infarction: A Source of Re‐entrant Premature Ventricular Contractions , 1973, Circulation.

[7]  R. Kępski,et al.  Noninvasive Recording of His‐Purkinje System (HPS) Activity in Man on Beat‐To‐Beat Basis , 1982, Pacing and clinical electrophysiology : PACE.

[8]  L Seipel,et al.  Non-invasive detection of late potentials in man--a new marker for ventricular tachycardia. , 1981, European heart journal.

[9]  R Lazzara,et al.  Characterization and Localization of Ventricular Arrhythmias Resulting from Myocardial Ischemia and Infarction , 1974, Circulation research.

[10]  D. Durrer,et al.  EPICARDIAL AND INTRAMURAL EXCITATION IN CHRONIC MYOCARDIAL INFARCTION. , 1964, American heart journal.

[11]  V. Hombach,et al.  [Continuous registration of micropotentials of the human heart. Initial experiences with a new high resolution ECG amplifier system]. , 2008, Deutsche medizinische Wochenschrift.

[12]  R. Sung,et al.  Significance of Fragmented Ventricular Electrograms Observed Using Intracardiac Recording Techniques in Man , 1980, Circulation.