Sasaki Y, Furihata A, Suyama K
Scecond Departmetn of Internal Medicine, Shinshu University School of Medicine, Nagano, Japan.
Pacing Clin Electrophysiol. 1994 Sep;17(9):1477-86. doi: 10.1111/j.1540-8159.1994.tb01512.x.
We compared signal-averaged electrocardiography (SAE), SAE mapping, and left ventricular catheter mapping in 60 patients with ischemic heart disease. Using the data obtained in patients with no fragmented electrograms (FE) in the left ventricle, the late potential was defined by SAE as a filtered QRS duration > 131 msec or a root mean square voltage < 16 microV for the last 40 msec of the QRS complex. SAE mapping was performed by recording the signal-averaged electrocardiogram at 48 sites on the body surface. With SAE mapping, the filtered QRS duration and the area in the last 20 msec of the QRS complex were significantly different between the patients with and without FEs. The late potential was defined by SAE mapping as a filtered QRS duration > 136 msec or an area < 28 microV.msec for the last 20 msec of the QRS complex. The sensitivity and specificity of detecting FEs were 46% and 88%, respectively, by the SAE filtered QRS criterion, while they were 66% and 88% by the root mean square criterion. In contrast, SAE mapping gave values of 66% and 92% by the filtered QRS criterion, as well as values of 100% and 92% by the area criterion. Thus, SAE mapping provided better detection of the FE and was more closely correlated with the results of catheter mapping, suggesting its potential for clinical application.
我们对60例缺血性心脏病患者进行了信号平均心电图（SAE）、SAE标测和左心室导管标测。利用左心室无碎裂电图（FE）患者的数据，SAE将晚期电位定义为滤波后的QRS波时限>131毫秒或QRS波群最后40毫秒的均方根电压<16微伏。SAE标测通过记录体表48个部位的信号平均心电图来进行。通过SAE标测，有和无FE的患者之间，滤波后的QRS波时限以及QRS波群最后20毫秒的面积存在显著差异。SAE标测将晚期电位定义为滤波后的QRS波时限>136毫秒或QRS波群最后20毫秒的面积<28微伏·毫秒。根据SAE滤波后的QRS波标准，检测FE的敏感性和特异性分别为46%和88%，而根据均方根标准则分别为66%和88%。相比之下，根据滤波后的QRS波标准，SAE标测得出的敏感性和特异性值分别为66%和92%，根据面积标准则分别为100%和92%。因此，SAE标测对FE的检测效果更好，且与导管标测结果的相关性更强，表明其具有临床应用潜力。
