The Signal-Averaged ECG Obtained by a New Digital Holter Recording System

Background: The implementation of signal-averaged analysis in the Holter recording may increase cost-effectiveness and enables further insights into pathophysiological links between arrhythmia genesis and time related modulating factors. This study assesses the feasibility of a new digitizing long-term recorder system to perform a signal-averaged analysis and compares the data with the results achieved by an established bedside real-time recording system. Methods: The study was performed prospectively in 22 patients. The digital recorder FD-3 obtained a 3-channel 24-hour Holter monitoring. For the signal-averaged ECG analysis, a template averaging was achieved in 5-minute periods. The interpolated sampling rate was 1024 Hz. The signal-averaged ECG by bedside real-time system was performed using the Predictor system. At 25-250 Hz and 40-250 Hz band-pass filter, 4 FD-3 epochs acquired in a 6-hour interval were chosen and the mean values of QRS, root mean square (RMS), and low amplitude signal (LAS) were compared with the data obtained by one Predictor measurement. Results: The regression analysis shows a positive correlation between the FD-3 and Predictor data of QRS, RMS, and LAS at both filter settings except for LAS at 25-250 Hz. Regarding the late potential classification, at 25-250 Hz 4 of 22 (18%) FD-3 and Predictor classifications were not coherent and at 40-250 Hz only 2 of 22 (9%) classifications did not correlate. Conclusions: The FD-3 recorder is feasible to perform a signal-averaged ECG analysis. Especially at 40-250 Hz, the late potential classification shows a concordant distribution.