Opolski G, Kraska T, Słomka K, Manowiec G, Wardaszko T
Department of Cardiology, Medical Academy, Warsaw, Poland.
Cor Vasa. 1988;30(5):331-7.
Signal-averaged electrocardiograms (ECGs) were registered before hospital discharge in 120 consecutive patients (pts) with first acute myocardial infarction (MI). 26 pts (22%) had abnormal signal-averaged ECGs - late potentials (LP). Pts with LP had a more serious clinical course than pts without LP: sustained ventricular tachycardia (VT) (27% vs. 2%; p less than 0.01), left ventricular aneurysm (35% vs. 11%; p much less than 0.05) and greater infarct size (62 +/- 35 vs. 43 +/- 22 CK-MB gEq; p less than 0.01). Complex ventricular ectopic activity was more often in pts with LP than in those without LP (54% vs. 28%; p less than 0.05). During an up to 18-month follow-up (mean 13) 6 pts presented sustained VT and 2 died suddenly. 5 pts with sustained VT and 2 pts who died suddenly had LP. The sensitivity of the signal-averaged ECG as a predictor of arrhythmic events was 86%, with a specificity of 82%. Signal-averaged ECGs provide prognostic information in identifying arrhythmic events after MI.
对120例连续的首次急性心肌梗死（MI）患者在出院前进行了信号平均心电图（ECG）检查。26例患者（22%）的信号平均ECG异常——出现晚电位（LP）。有LP的患者比没有LP的患者临床病程更严重：持续性室性心动过速（VT）（27%对2%；p<0.01）、左心室室壁瘤（35%对11%；p<<0.05）以及梗死面积更大（肌酸激酶同工酶[CK-MB]总量为62±35对43±22 gEq；p<0.01）。有LP的患者比没有LP的患者更常出现复杂室性异位活动（54%对28%；p<0.05）。在长达18个月的随访期（平均13个月）内，6例患者出现持续性VT，2例猝死。5例出现持续性VT的患者和2例猝死患者有LP。信号平均ECG作为心律失常事件预测指标的敏感性为86%，特异性为82%。信号平均ECG在识别MI后心律失常事件方面可提供预后信息。
