Optimal high-pass filter settings of the signal-averaged electrocardiogram in patients with arrhythmogenic right ventricular dysplasia

Abstract

Signal-averaged electrocardiography has been used to detect late potentials in patients at risk of sustained ventricular tachycardia.t The reported prevalence of abnormal signals has ranged from 60% to 90% in patients with previously documented episodes of chronic sustained ventricular tachycardia after myocardial infarction. High-pass filter settings at 25 or 40 Hz are usually selected, although different high-pass filters can significantly change the criteria for identifying late potentials. The effect of the high-pass filter for signal averaging of the surface QRS complex to detect late potentials was assessed by Gomes2 and Carets and their associates. However, these studies depend on the data from patients with ventricular tachycardia who had coronary artery disease or idiopathic dilated cardiomyopathy. There are no widely accepted guidelines for the optimal high-pass filter settings in patients with arrhythmogenic right ventricular dysplasia (ARVD), who had ventricular tachycardia originating from the right ventricle, and had normal left ventricular function. The purpose of this study was to establish the optimal high-pass filter settings for the signal-averaged electrocardiogram (ECG) in patients with ARVD. The signal-averaged ECG was recorded in 30 patients (20 men and 10 women, mean age 37.8 f 13.3 years) with ARVD, who had clinically sustained ventricular tachycardia. Diagnosis of ARVD was achieved by ECGs during ventricular tachycardia and sinus rhythm, echocardiograms, right and left ventricular angiograms, and electrophysiologic studies. QRS morphologies during ventricular tachycardias were left bundle branch block pattern, and the origins of ventricular tachycardia were right ventricle in all. Patients with From the Center de Stimulation Cardiaque et de Rythmologie, HBpital Jean Rostand, Ivry-Sur-Seine, Ivry, France. Dr. Kinoshita’s address is: HBpital Jean Rostand, 39-41, rue Jean Le Galleu, 94200 Ivry&u-Seine,