Effects of antiarrhythmic surgery on late ventricular potentials recorded by precordial signal averaging in patients with ventricular tachycardia

Abstract

In seven patients with documented ventricular tachycardia (VT) and prior myocardial infarction, late potentials (LP) were recorded at the end of or after the QRS complex from the body surface using high-gain amplification and the signal averaging technique (RC filter settings 100 to 300 Hz). In 6 of 7 patients VT could be initiated by programmed right ventricular stimulation; in one case, VT was inducible only from the left ventricle during surgery. Surgery was guided by epi- and endocardial mapping. In most cases besides resection of scar tissue, a partial or complete subendocardial encircling ventriculotomy was performed. Postoperatively, LPs were abolished in five cases, VT being no longer inducible. In the remaining two patients, LPs were still present. VT was still inducible in one of these two cases whereas in the other case, no programmed testing was done postoperatively. These data suggest that the abolition of LPs by surgery is closely related to the disappearance of the propensity to stimulus-induced VT. Thus, the averaging technique represents a new approach to the noninvasive control of the efficacy of surgery in patients with VT and prior myocardial infarction.