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Circulation, Vol 64, 235-242, Copyright © 1981 by American Heart Association
MB Simson
Small, high-frequency electrocardiographic signals were recorded from the
body surface in 39 patients with and 27 patients without ventricular
tachycardia (VT). All patients were in normal sinus rhythm, had a previous
myocardial infarction, were not taking antiarrhythmic drugs, and did not
have bundle branch block. Bipolar X, Y, Z leads were signal averaged and
processed by a bidirectional digital filter that allowed low-amplitude
signals to be detected in the terminal QRS complex and ST segment. The
high-pass filter frequency was 25 Hz. Patients with VT had a lower
amplitude of high-frequency signal in the late QRS complex. In the last 40
msec of the filtered QRS complex, the patients with VT had 14.9 +/- 14.4
microV of high-frequency signal; patients without VT had 73.8 +/- 47.7
microV (p less than 0.0001). Ninety-two percent of the patients with VT had
less than 25 microV of high-frequency voltage; only 7% of patients without
VT had less than 25 microV (p less than 0.0001). Patients with VT had a
longer QRS duration than those without VT, 139 +/- 26 vs 95 +/- 10 msec (p
less than 0.0001). The QRS duration was longer than 120 msec in 72% of the
patients with VT but in none of the patients without VT (p less than
0.0001). In all patients there was no separate and discrete high- frequency
signal in the ST segment. Advanced signal processing of the ECG accurately
identified the patients in the study with VT after myocardial infarction.
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Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction
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