Ivanov G G, Kovtun V V, Kago M, Titomir L I
Laboratory of Computer Technology in Medicine, Faculty of Basic Medicine, Moscow State University, Russia.
Can J Cardiol. 1996 Jan;12(1):53-8.
To evaluate the signal-averaged high resolution electrocardiogram in the time domain and the frequency domain in various cardiac patients.
Patients in seven clinical diagnostic categories were compared with a healthy control group.
The control group consisted of 70 clinically healthy persons. The 525 cardiac patients were divided as follows: group 1, 29 patients with surgically corrected mitralvalvular disease; group 2, 42 postinfarction patients with-bypass grafting; group 3, 57 patients with ventricular tachycardia; group 4, 198 patients with medically treated angina; group 5, 63 patients with hypertension; group 6, 46 patients with paroxysmal atrial fibrillation; and group 7, 90 patients with acute pulmonary insufficiency. The Frank orthogonal leads were used to derive the signal-averaged electrocardiogram in the usual manner by averaging over 200 complexes. Time domain and frequency domain data were recorded for both the P wave and the QRS complex.
Ventricular late potentials were found most often in patients with postinfarction ventricular tachycardia (59%). The prevalence of ventricular late potentials in the mitral valvular disease group increased from 45% to 70% after surgery; in the bypass grafting group it also increased. Spectral temporal mapping revealed a substantial decrease of the total spectral power in the bypass grafting group, to 129 +/- 19 microV2/Hz compared with the preoperative period (205 +/- 16 microV2/Hz). The high frequency power decreased, so the ratio of low frequency to high frequency power increased. A significant correlation was found between the root-mean-square signal in the last 40 ms of the QRS complex and each of the amplitude parameter, the frequency domain localization and time domain localization of the power density peaks.
High resolution electrocardiography including time domain and frequency domain analyses may prove helpful in diagnosis and management.
评估不同心脏疾病患者时域和频域的信号平均高分辨率心电图。
将七个临床诊断类别的患者与健康对照组进行比较。
对照组由70名临床健康者组成。525名心脏病患者分组如下：第一组，29例接受二尖瓣手术矫正的患者；第二组，42例心肌梗死后接受搭桥手术的患者；第三组，57例室性心动过速患者；第四组，198例接受药物治疗的心绞痛患者；第五组，63例高血压患者；第六组，46例阵发性心房颤动患者；第七组，90例急性肺功能不全患者。采用Frank正交导联，以常规方式通过对200个心动周期进行平均来获取信号平均心电图。记录P波和QRS波群的时域和频域数据。
心肌梗死后室性心动过速患者中最常发现心室晚电位（59%）。二尖瓣疾病组心室晚电位的发生率在手术后从45%增至70%；搭桥手术组也有所增加。频谱时间映射显示，搭桥手术组的总频谱功率大幅下降，与术前（205±16μV²/Hz）相比降至129±19μV²/Hz。高频功率降低，低频与高频功率之比增加。在QRS波群最后40毫秒的均方根信号与各振幅参数、功率密度峰值的频域定位和时域定位之间发现显著相关性。
包括时域和频域分析的高分辨率心电图可能有助于诊断和治疗。
