Gatzoulis Konstantinos A, Arsenos Petros, Trachanas Konstantinos, Dilaveris Polychronis, Antoniou Christos, Tsiachris Dimitris, Sideris Skevos, Kolettis Theofilos M, Tousoulis Dimitrios
Electrophysiology Laboratory and First University Department of Cardiology Hippokration General Hospital National and Kapodestrian University of Athens Athens Greece.
Department of Cardiology Hippokration General Hospital Athens Greece.
J Arrhythm. 2018 May 28;34(3):222-229. doi: 10.1002/joa3.12062. eCollection 2018 Jun.
Signal-averaged electrocardiography records delayed depolarization of myocardial areas with slow conduction that can form the substrate for monomorphic ventricular tachycardia. This technique has been examined mostly in patients with coronary artery disease, but its use has been declined over the years. However, several lines of evidence, derived from hitherto clinical data in patients with healed myocardial infarction, indicate that signal-averaged electrocardiography remains a valuable tool in risk stratification, especially when incorporated into algorithms encompassing invasive and noninvasive indices. Such an approach can aid the more precise identification of candidates for device therapy, in the context of primary prevention of sudden cardiac death. This article reappraises the value of signal-averaged electrocardiography as a predictor of arrhythmic outcome in patients with ischemic heart disease and discusses potential future indications.
信号平均心电图记录了心肌区域缓慢传导导致的延迟去极化，而这种缓慢传导可形成单形性室性心动过速的基质。这项技术主要在冠心病患者中进行了研究，但多年来其应用已有所减少。然而，从心肌梗死愈合患者的现有临床数据中得出的几条证据表明，信号平均心电图在风险分层中仍然是一种有价值的工具，特别是当它被纳入包含有创和无创指标的算法中时。在心脏性猝死的一级预防背景下，这种方法有助于更精确地识别适合器械治疗的患者。本文重新评估了信号平均心电图作为缺血性心脏病患者心律失常结局预测指标的价值，并讨论了其未来潜在的应用指征。
