Copie X, Hnatkova K, Staunton A, Camm A J, Malik M
Department of Cardiological Sciences, St. George's Hospital Medical School, London, England.
J Cardiovasc Electrophysiol. 1996 Jul;7(7):583-93. doi: 10.1111/j.1540-8167.1996.tb00566.x.
Spectral turbulence analysis of the signal-averaged ECG (SAECG) combines spectral analysis with statistical evaluation of spectrograms of individual parts of the QRS complex. It has been suggested that it may be superior to conventional time-domain analysis of the SAECG.
This study compared the power of conventional time-domain (40 to 250 Hz) and spectral turbulence analyses of SAECG for the prediction of cardiac death, ventricular tachycardia, sudden arrhythmic death, and arrhythmic events (ventricular tachycardia or fibrillation, and/or sudden arrhythmic death) after acute myocardial infarction in 603 patients. The population excluded patients with bundle branch block and other conduction abnormalities. During the first 2 years of follow-up, there were 40 cardiac deaths, 21 cases of ventricular tachycardia, 1 sudden arrhythmic deaths, and 29 arrhythmic events. The positive predictive accuracy of spectral turbulence analysis was significantly higher than time-domain analysis for cardiac death at most levels of sensitivity (e.g., 26% vs 20% at 40% sensitivity, P < 0.05). The positive predictive accuracies of the two techniques were not statistically different for the prediction of ventricular tachycardia. For the prediction of sudden arrhythmic death and arrhythmic events, the positive predictive accuracy of spectral turbulence was better than that of time-domain analysis only at the higher levels of sensitivity (9% vs 2%, P < 0.001 for sudden arrhythmic death at 60% sensitivity, and 14% vs 11%, P < 0.05 for arrhythmic events at 60% sensitivity).
Spectral turbulence analysis is essentially equivalent to time-domain analysis for the prediction of arrhythmic events after myocardial infarction. However, it performed significantly better than time-domain analysis for the prediction of cardiac death.
信号平均心电图（SAECG）的频谱湍流分析将频谱分析与QRS波群各部分频谱图的统计评估相结合。有人提出，它可能优于SAECG的传统时域分析。
本研究比较了SAECG的传统时域分析（40至250Hz）和频谱湍流分析对603例急性心肌梗死后心脏死亡、室性心动过速、心律失常性猝死和心律失常事件（室性心动过速或颤动和/或心律失常性猝死）的预测能力。该人群排除了束支传导阻滞和其他传导异常的患者。在随访的前两年中，有40例心脏死亡、21例室性心动过速、1例心律失常性猝死和29例心律失常事件。在大多数敏感性水平下，频谱湍流分析对心脏死亡的阳性预测准确性显著高于时域分析（例如，在40%敏感性时为26%对20%，P<0.05）。两种技术对室性心动过速预测的阳性预测准确性无统计学差异。对于心律失常性猝死和心律失常事件的预测，仅在较高敏感性水平下，频谱湍流的阳性预测准确性优于时域分析（在60%敏感性时，心律失常性猝死为9%对2%，P<0.001；在60%敏感性时，心律失常事件为14%对11%，P<0.05）。
频谱湍流分析在预测心肌梗死后心律失常事件方面与时域分析基本等效。然而，在预测心脏死亡方面，它的表现明显优于时域分析。
