ABSTRACT
High amplification electrocardiographic recording of ventricular late potentials was introduced a few years ago and seems to be a simple, reliable and reproducible method to identify patients at a high risk of sudden death and ventricular tachycardia, principally during the chronic phase of myocardial infarction. However, few authors have studied quantitatively the prevalence of late potentials in patients with ventricular tachycardia compared with a sufficiently large sample of healthy subjects. In this study 34 patients with sustained ventricular tachycardia (11 women, 23 men, mean age 58 years) and 131 healthy subjects (29 women, 102 men, mean age 29 years) underwent high amplification time-averaged ECG recording, and an algorithmic analysis of the tracings was conducted, using the Simson method. Three numeric parameters were used in the interpretation of the tracings: HFRMSA = mean RMS amplitude of the last 40 milliseconds of QRS; HFD40 = delay in signal decrease from amplitude 40 mu v to baseline, and delta QRS = difference in QRS duration with 0-250 Hz and 25-250 Hz filterings. Normal values, as determined from measurements in healthy subjects, were: HFRMSA above 27 mu v, HFD40 below 35 ms and delta QRS below 13 ms. Late potentials were present when at least one of these criteria was positive. When these norms were applied to patients with sustained ventricular tachycardia the prevalence of late potentials was 76%, rising to 90.4% in the subgroup of 21 patients with coronary disease. With the method thus defined the specificity for each criterion taken separately is 97.5%. According to the norms, only one control subject (0.8%) gave a false-positive result.(ABSTRACT TRUNCATED AT 250 WORDS)
