Signal-averaged electrocardiography in hypertrophic cardiomyopathy

Cripps, Tim R., Counihan, Peter J., Frenneaux, Micahel P., Ward, David E., Camm, A. John and McKenna, William J. (1990) Signal-averaged electrocardiography in hypertrophic cardiomyopathy. Journal of the American College of Cardiology, 15 (5). pp. 956-61. ISSN 0735-1097

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A major goal in the management of patients with hypertrophic cardiomyopathy is the prediction of sudden death. To evaluate the high gain signal-averaged electrocardiogram (ECG) in this setting, 64 patients with hypertrophic cardiomyopathy and 50 age- and gender-matched control subjects were studied. An abnormal signal-averaged ECG was more common in patients than in control subjects: 13 (20%) of 64 patients with hypertrophic cardiomyopathy had abnormalities compared with 2 (4%) of the 50 control subjects (p less than 0.001). There was a significant association between the presence of nonsustained ventricular tachycardia on 48 h ECG Holter monitoring and the presence of an abnormal signal-averaged ECG: 8 (47%) of the 17 patients with nonsustained ventricular tachycardia and 6 (86%) of 7 patients with more than three episodes of nonsustained ventricular tachycardia per 24 h had signal-averaged ECG abnormalities. There was no association between an abnormal signal-averaged ECG and a family history of premature sudden cardiac death, a history of syncope, symptomatic status, maximal left ventricular wall thickness, the presence of systolic anterior motion of the mitral valve or maximal rate of oxygen uptake on exercise. However, of four patients with a history of cardiac arrest, three had an abnormal signal-averaged ECG. Sensitivity was 50%; specificity was 93% and positive predictive accuracy was 77% for the signal-averaged ECG in detecting patients with electrical instability (defined as a history of cardiac arrest or the presence of nonsustained ventricular tachycardia, or both).(ABSTRACT TRUNCATED AT 250 WORDS)

Item Type: Article
Uncontrolled Keywords: adolescent,adult,aged,cardiomyopathy, hypertrophic,death, sudden,echocardiography,electrocardiography,electrocardiography, ambulatory,exercise test,female,humans,male,middle aged,signal processing, computer-assisted
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Depositing User: Pure Connector
Date Deposited: 27 Feb 2015 13:14
Last Modified: 23 Apr 2023 00:58
DOI: 10.1016/0735-1097(90)90223-C

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