Clinical significance of non-invasively recorded ventricular late potentials

L. Goedel-Meinen, M. Hofmann, G. Schmidt, G. Jahns, W. Baedeker

Research output: Contribution to journalArticlepeer-review

Abstract

Since they were first discovered in 1978, ventricular late potentials have become of increasing clinical interest. Late potentials can be regarded as signifying impeded conduction in specific areas of the myocardium. As these areas are quite small in comparison to the total mass of the ventricular myocardium, their potentials on the body surface show an amplitude of only a few μV. The noninvasive registration of these potentials is made possible through high amplification, filtering and signal-averaging. Abnormal readings in the signal-averaged ECG of normal healthy individuals are rare. In patients with dilative cardiomyopathy 34 to 42% showed late potentials; in patients with coronary heart disease, 22 to 63% displayed them. In the acute phase of myocardial infarction, the variability of late potentials is apparently increased; in its chronic phase, however, late potentials show an essentially higher reproducibility. The highest percentage of abnormal reading is found in patients with sustained ventricular arrhythmias. Also, the greatest prognostic significance of late potentials appears to be related to the incidence of ventricular tachycardias. While the periodic evaluation after heart transplantation represents a new field of application for the signal-averaged ECG, its value for therapy control after antiarrhythmic medication, it becomes clear that class IA, B and C antiarrhythmic agents exert a distinctly different influence on the signal-averaged ECG; a clinically useful connection between the signal-averaged ECG readings and the efficacy assessment of antiarrhythmic therapy using Holter-monitoring has not been proved up to this time, however. Altogether, it can be stated that the noninvasive measurement of ventricular late potentials represents a relatively new method which, as any new procedure, requires further clinical investigation.

Original languageEnglish
Pages (from-to)92-99
Number of pages8
JournalInnere Medizin
Volume15
Issue number3
StatePublished - 1988
Externally publishedYes

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