Standards for analysis of ventricular late potentials using high-resolution or signal-averaged electrocardiography: a statement by a task force committee of the European Society of Cardiology, the American Heart Association, and the American College of Cardiology.

Sufficient data are available to recommend the use of the high-resolution or signal-averaged electrocardiogram in patients recovering from myocardial infarction without bundle branch block to help determine their risk for developing sustained ventricular tachyarrhythmias. However, no data are available about the extent to which pharmacological or nonpharmacological interventions in patients with late potentials have an impact on the incidence of sudden cardiac death. Therefore, controlled, prospective studies are required before this issue can be resolved. As refinements in techniques evolve, it is anticipated that the clinical value of high-resolution or signal-averaged electrocardiography will continue to increase.

[1]  A H Harken,et al.  Relation between late potentials on the body surface and directly recorded fragmented electrograms in patients with ventricular tachycardia. , 1983, The American journal of cardiology.

[2]  P. Denes,et al.  Quantitative Analsis of the High‐frequency Components of the Terminal Portion of the Body Surface QRS in Normal Subjects and in Patients with Ventricular Tachycardia , 1983, Circulation.

[3]  A. Murray,et al.  Delayed ventricular depolarization--correlation with ventricular activation and relevance to ventricular fibrillation in acute myocardial infarction. , 1984, European heart journal.

[4]  D. Durrer,et al.  The electrocardiogram in normal and some abnormal conditions; in revived human fetal heart and in acute and chronic coronary occlusion. , 1961, American heart journal.

[5]  D L Ross,et al.  Prognostic significance of ventricular tachycardia and fibrillation induced at programmed stimulation and delayed potentials detected on the signal-averaged electrocardiograms of survivors of acute myocardial infarction. , 1986, Circulation.

[6]  J. Spear,et al.  Electrophysiologic and anatomic correlates of sustained ventricular tachyarrhythmias in a model of chronic myocardial infarction. , 1980, The American journal of cardiology.

[7]  N. Sammel,et al.  Prediction of serious arrhythmic events after myocardial infarction: signal-averaged electrocardiogram, Holter monitoring and radionuclide ventriculography. , 1987, Journal of the American College of Cardiology.

[8]  G. Breithardt,et al.  Effects of antiarrhythmic surgery on late ventricular potentials recorded by precordial signal averaging in patients with ventricular tachycardia. , 1982, American heart journal.

[9]  N. Sammel,et al.  Late potentials detected after myocardial infarction: natural history and prognostic significance. , 1986, Circulation.

[10]  P. Savard,et al.  Mapping of ventricular tachycardia induced by programmed stimulation in canine preparations of myocardial infarction. , 1984, Circulation.

[11]  N. Sammel,et al.  Signal-averaged electrocardiogram for evaluation of recurrent syncope. , 1986, The American journal of cardiology.

[12]  L. Horowitz,et al.  Sustained ventricular tachycardia: evidence for protected localized reentry. , 1978, The American journal of cardiology.

[13]  J M Fontaine,et al.  Value of the signal-averaged electrocardiogram as a predictor of the results of programmed stimulation in nonsustained ventricular tachycardia. , 1988, The American journal of cardiology.

[14]  J E Saffitz,et al.  Intramural Reentry as a Mechanism of Ventricular Tachycardia during Evolving Canine Myocardial Infarction , 1985, Circulation research.

[15]  J. Windle,et al.  Fast Fourier transformation of the entire low amplitude late QRS potential to predict ventricular tachycardia. , 1989, Journal of the American College of Cardiology.

[16]  S. Abboud,et al.  Effect of thrombolysis on the evolution of late potentials within 10 days of infarction. , 1990, British heart journal.

[17]  P. Ursell,et al.  Electrophysiologic and anatomic basis for fractionated electrograms recorded from healed myocardial infarcts. , 1985, Circulation.

[18]  D A Richards,et al.  Electrophysiologic substrate for ventricular tachycardia: correlation of properties in vivo and in vitro. , 1984, Circulation.

[19]  R. Fenici,et al.  Failure of signal-averaging-technique to record arrhythmogenic diastolic potentials: advantage of non-invasive beat for beat recording , 1983 .

[20]  M Borggrefe,et al.  Recent advances in the identification of patients at risk of ventricular tachyarrhythmias: role of ventricular late potentials. , 1987, Circulation.

[21]  R. M. Arthur,et al.  Spectral and temporal interrogation of signal-averaged electrocardiograms: the best is yet to come. , 1989, Journal of the American College of Cardiology.

[22]  E. Caref,et al.  Risk stratification and management of patients with organic heart disease and nonsustained ventricular tachycardia: role of programmed stimulation, left ventricular ejection fraction, and the signal-averaged electrocardiogram. , 1990, The American journal of medicine.

[23]  J M de Bakker,et al.  Reentry as a cause of ventricular tachycardia in patients with chronic ischemic heart disease: electrophysiologic and anatomic correlation. , 1988, Circulation.

[24]  A. Osterspey,et al.  Assessment of Ventricular Vulnerability by Holter ECG, Programmed Ventricular Stimulation and Recording of Ventricular Late Potentials , 1983 .

[25]  B. Lindsay,et al.  Improved differentiation of patients with and without ventricular tachycardia by frequency analysis of multiple electrocardiographic leads. , 1988, The American journal of cardiology.

[26]  E. Caref,et al.  Role of bandpass filters in optimizing the value of the signal-averaged electrocardiogram as a predictor of the results of programmed stimulation. , 1989, The American journal of cardiology.

[27]  E. Gang,et al.  Detection of late potentials on the surface electrocardiogram in unexplained syncope. , 1986, The American journal of cardiology.

[28]  P. Crean,et al.  An echocardiographic study of localized subaortic hypertrophy. , 1986, European heart journal.

[29]  L. Horowitz,et al.  Recurrent Sustained Ventricular Tachycardia: 1. Mechanisms , 1978, Circulation.

[30]  R Lazzara,et al.  The Pathophysiology of Malignant Ventricular Arrhythmias During Acute Myocardial Ischemia , 1974, Circulation.

[31]  J. Spear,et al.  Inducible sustained ventricular tachycardia 4 years after experimental canine myocardial infarction: electrophysiologic and anatomic comparisons with early healed infarcts. , 1988, Circulation.

[32]  G. Breithardt,et al.  Prevalence of late potentials in patients with and without ventricular tachycardia: correlation with angiographic findings. , 1982, The American journal of cardiology.

[33]  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.

[34]  N. El-Sherif,et al.  Reentrant Ventricular Arrhythmias in the Late Myocardial Infarction Period 9. Electrophysiologic-Anatomic Correlation of Reentrant Circuits , 1983, Circulation.

[35]  B. Lindsay,et al.  Improved selection of patients for programmed ventricular stimulation by frequency analysis of signal-averaged electrocardiograms. , 1986, Circulation.

[36]  N. El-Sherif,et al.  Canine Ventricular Arrhythmias in the Late Myocardial Infarction Period , 1981, Circulation research.

[37]  G. Breithardt,et al.  Ventricular late potentials and inducible ventricular tachyarrhythmias as a marker for ventricular tachycardia after myocardial infarction. , 1986, European heart journal.

[38]  J. Bigger,et al.  Importance of the endpoint of noise reduction in analysis of the signal-averaged electrocardiogram. , 1989, The American journal of cardiology.

[39]  N. El-Sherif,et al.  Correlation between the signal-averaged electrocardiogram from Holter tapes and from real-time recordings. , 1989, The American journal of cardiology.

[40]  E. Caref,et al.  The signal-averaged electrocardiogram and late potentials. A comparative analysis of commercial devices. , 1989, Journal of electrocardiology.

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

[42]  W Craelius,et al.  Electrophysiological Basis of Ventricular Late Potentials , 1990, Pacing and clinical electrophysiology : PACE.

[43]  B. Lindsay,et al.  Identification of patients with sustained ventricular tachycardia by frequency analysis of signal-averaged electrocardiograms despite the presence of bundle branch block. , 1988, Circulation.

[44]  M. Cain,et al.  Spectral analysis of the entire cardiac cycle from signal-averaged ECGs for the detection of patients prone to ventricular tachycardia , 1988, Proceedings. Computers in Cardiology 1988.

[45]  H. Karagueuzian,et al.  Protracted ventricular tachcardia induced by premature stimulation of the canine heart after coronary artery occlusion and reperfusion. , 1979, Circulation research.

[46]  B E Sobel,et al.  Fast-Fourier transform analysis of signal-averaged electrocardiograms for identification of patients prone to sustained ventricular tachycardia. , 1984, Circulation.

[47]  A. Wilde,et al.  Ventricular tachycardia in the infarcted, Langendorff-perfused human heart: role of the arrangement of surviving cardiac fibers. , 1990, Journal of the American College of Cardiology.

[48]  G. Breithardt,et al.  Late potentials as predictors of risk after thrombolytic treatment? , 1990, British heart journal.

[49]  R Haberl,et al.  Comparison of frequency and time domain analysis of the signal-averaged electrocardiogram in patients with ventricular tachycardia and coronary artery disease: methodologic validation and clinical relevance. , 1988, Journal of the American College of Cardiology.

[50]  M. Josephson,et al.  Entrainment of ventricular tachycardia: explanation for surface electrocardiographic phenomena by analysis of electrograms recorded within the tachycardia circuit. , 1988, Circulation.

[51]  S L Winters,et al.  A new noninvasive index to predict sustained ventricular tachycardia and sudden death in the first year after myocardial infarction: based on signal-averaged electrocardiogram, radionuclide ejection fraction and Holter monitoring. , 1987, Journal of the American College of Cardiology.

[52]  E. Gang,et al.  Decreased incidence of ventricular late potentials after successful thrombolytic therapy for acute myocardial infarction. , 1989, The New England journal of medicine.

[53]  G. Breithardt,et al.  Ventricular vulnerability assessed by programmed ventricular stimulation in patients with and without late potentials. , 1983, Circulation.

[54]  N. Flowers,et al.  Late potentials in normal subjects and in patients with ventricular tachycardia unrelated to myocardial infarction. , 1985, The American journal of cardiology.

[55]  I Wiener,et al.  Determinants of Ventricular Tachycardia in Patients with Ventricular Aneurysms: Results of Intraoperative Epicardial and Endocardial Mapping , 1982, Circulation.

[56]  Flowers Nc,et al.  Ventricular late potentials in normal subjects. , 1988 .

[57]  P. Macfarlane,et al.  Recommendations for standardization and specifications in automated electrocardiography: bandwidth and digital signal processing. A report for health professionals by an ad hoc writing group of the Committee on Electrocardiography and Cardiac Electrophysiology of the Council on Clinical Cardiology, , 1990, Circulation.

[58]  G. Breithardt,et al.  Pathophysiological mechanisms and clinical significance of ventricular late potentials. , 1986, European heart journal.

[59]  M. Josephson,et al.  Results of signal-averaged electrocardiography and electrophysiologic study in patients with nonsustained ventricular tachycardia after healing of acute myocardial infarction. , 1987, The American journal of cardiology.

[60]  J. Spear,et al.  Detection of delayed ventricular activation on the body surface in dogs. , 1981, The American journal of physiology.

[61]  N. El-Sherif,et al.  Reentrant ventricular arrhythmias in the late myocardial infarction period. Interruption of reentrant circuits by cryothermal techniques. , 1983, Circulation.

[62]  M. Josephson,et al.  Body surface late potentials: effects of endocardial resection in patients with ventricular tachycardia. , 1984, Circulation.

[63]  M Borggrefe,et al.  Prognostic significance of late ventricular potentials after acute myocardial infarction. , 1983, European heart journal.

[64]  H. Kennedy,et al.  Signal-averaged electrocardiography in the time and frequency domains. , 1989, The American journal of cardiology.

[65]  R. Califf,et al.  Comparison of time domain and frequency domain variables from the signal-averaged electrocardiogram: a multivariable analysis. , 1988, Journal of the American College of Cardiology.

[66]  M. Simson.  Use of Signals in the Terminal QRS Complex to Identify Patients with Ventricular Tachycardia After Myocardial Infarction , 1981, Circulation.

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

[68]  M. Josephson,et al.  Identification of patients with ventricular tachycardia after myocardial infarction: signal-averaged electrocardiogram, Holter monitoring, and cardiac catheterization. , 1984, Circulation.

[69]  D. Mortara,et al.  Body Surface Detection of Delayed Depolarizations in Patients with Recurrent Ventricular Tachycardia and Left Ventricular Aneurysm , 1981, Circulation.

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

[71]  A. Keren,et al.  Heart transplant rejection monitored by signal-averaged electrocardiography in patients receiving cyclosporine. , 1984, Circulation.

[72]  M Borggrefe,et al.  Methods for non-invasive detection of ventricular late potentials--a comparative multicenter study. , 1986, European heart journal.

[73]  A comparative study of frequency domain and time domain analysis of signal-averaged electrocardiograms in patients with ventricular tachycardia. , 1988, Journal of the American College of Cardiology.

[74]  M. Allessie,et al.  Electrophysiologic mapping to determine the mechanism of experimental ventricular tachycardia initiated by premature impulses. Experimental approach and initial results demonstrating reentrant excitation. , 1982, The American journal of cardiology.

[75]  R Lazzara,et al.  Re-entrant Ventricular Arrhythmias in the Late Myocardial Infarction Period: 3. Manifest and Concealed Extrasystolic Grouping , 1977, Circulation.

[76]  H. Kantarjian,et al.  Proposal for a simple synthesis prognostic staging system in chronic myelogenous leukemia. , 1990, The American journal of medicine.

[77]  E. Caref,et al.  Prognostic significance of the signal-averaged ECG depends on the time of recording in the postinfarction period. , 1989, American heart journal.

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

[79]  R Haberl,et al.  Spectral mapping of the electrocardiogram with Fourier transform for identification of patients with sustained ventricular tachycardia and coronary artery disease. , 1989, European heart journal.

[80]  A L Waldo,et al.  Intraoperative Electrophysiologic Mapping of the Ventricles During Sinus Rhythm in Patients with a Previous Myocardial Infarction Identification of the Electrophysiologic Substrate of Ventricular Arrhythmias , 1982, Circulation.

[81]  K. Peterson,et al.  The development of the entire end-systolic pressure-volume and ejection fraction-afterload relations: a new concept of systolic myocardial stiffness. , 1987, Circulation.

[82]  S L Winters,et al.  Signal averaging of the surface QRS complex predicts inducibility of ventricular tachycardia in patients with syncope of unknown origin: a prospective study. , 1987, Journal of the American College of Cardiology.

[83]  R Lazzara,et al.  Recording from the body surface of arrhythmogenic ventricular activity during the S-T segment. , 1978, The American journal of cardiology.

[84]  H. Wellens,et al.  Observations on Mechanisms of Ventricular Tachycardia in Man , 1976, Circulation.

[85]  G. Steinbeck,et al.  Frequency analysis of the surface electrocardiogram for recognition of acute rejection after orthotopic cardiac transplantation in man. , 1987, Circulation.