Differences in electrophysiological substrate in patients with coronary artery disease and cardiac arrest or ventricular tachycardia: Insights from endocardial mapping and signal-averaged electrocardiography

Paul T. Vaitkus, K. Elizabeth Kindwall, Francis E. Marchlinski, John Miller, Alfred E. Buxton, Mark E. Josephson

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background. Many studies have combined patients with hemodynamically well-tolerated ventricular tachycardia (VT) and those with cardiac arrest (CA) as a single, homogenous group. Recent studies suggest that these two groups have different electrophysiological substrates and responses to therapy. Most of these studies, however, enrolled patients with a variety of cardiac diagnoses. Methods and Results. We used signal-averaged electrocardiography (SAECG) and endocardial catheter mapping to define the electrophysiological substrate in patients with coronary artery disease and VT or CA and correlate the results of the two methods. We also examined the usefulness of SAECG in CA patients to differentiate those with inducible arrhythmias from those who are noninducible. VT patients were more likely to have had a prior myocardial infarction (p=0.0005) and to have inducible arrhythmias (p=0.0001) than were CA patients. The induced arrhythmias in patients who presented with VT was VT in more than 90% of cases, whereas in CA patients, polymorphic ventricular tachycardia (PMVT) accounted for one third of induced arrhythmias. Mean filtered QRS duration was longer (135 versus 120 msec) and the terminal QRS voltage was smaller (20 versus 34 μV) in VT than in CA patients (p

Original languageEnglish (US)
Pages (from-to)672-678
Number of pages7
JournalCirculation
Volume84
Issue number2
StatePublished - Aug 1991
Externally publishedYes

Fingerprint

Ventricular Tachycardia
Heart Arrest
Coronary Artery Disease
Electrocardiography
Cardiac Arrhythmias
Catheters
Myocardial Infarction

Keywords

  • Cardiac arrest
  • Coronary artery disease
  • Electrocardiography, signal-averaged
  • Electrophysiology
  • Mapping
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Differences in electrophysiological substrate in patients with coronary artery disease and cardiac arrest or ventricular tachycardia : Insights from endocardial mapping and signal-averaged electrocardiography. / Vaitkus, Paul T.; Kindwall, K. Elizabeth; Marchlinski, Francis E.; Miller, John; Buxton, Alfred E.; Josephson, Mark E.

In: Circulation, Vol. 84, No. 2, 08.1991, p. 672-678.

Research output: Contribution to journalArticle

@article{7fb87a5d4e304fcab5591213d73f2867,
title = "Differences in electrophysiological substrate in patients with coronary artery disease and cardiac arrest or ventricular tachycardia: Insights from endocardial mapping and signal-averaged electrocardiography",
abstract = "Background. Many studies have combined patients with hemodynamically well-tolerated ventricular tachycardia (VT) and those with cardiac arrest (CA) as a single, homogenous group. Recent studies suggest that these two groups have different electrophysiological substrates and responses to therapy. Most of these studies, however, enrolled patients with a variety of cardiac diagnoses. Methods and Results. We used signal-averaged electrocardiography (SAECG) and endocardial catheter mapping to define the electrophysiological substrate in patients with coronary artery disease and VT or CA and correlate the results of the two methods. We also examined the usefulness of SAECG in CA patients to differentiate those with inducible arrhythmias from those who are noninducible. VT patients were more likely to have had a prior myocardial infarction (p=0.0005) and to have inducible arrhythmias (p=0.0001) than were CA patients. The induced arrhythmias in patients who presented with VT was VT in more than 90{\%} of cases, whereas in CA patients, polymorphic ventricular tachycardia (PMVT) accounted for one third of induced arrhythmias. Mean filtered QRS duration was longer (135 versus 120 msec) and the terminal QRS voltage was smaller (20 versus 34 μV) in VT than in CA patients (p",
keywords = "Cardiac arrest, Coronary artery disease, Electrocardiography, signal-averaged, Electrophysiology, Mapping, Ventricular tachycardia",
author = "Vaitkus, {Paul T.} and Kindwall, {K. Elizabeth} and Marchlinski, {Francis E.} and John Miller and Buxton, {Alfred E.} and Josephson, {Mark E.}",
year = "1991",
month = "8",
language = "English (US)",
volume = "84",
pages = "672--678",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Differences in electrophysiological substrate in patients with coronary artery disease and cardiac arrest or ventricular tachycardia

T2 - Insights from endocardial mapping and signal-averaged electrocardiography

AU - Vaitkus, Paul T.

AU - Kindwall, K. Elizabeth

AU - Marchlinski, Francis E.

AU - Miller, John

AU - Buxton, Alfred E.

AU - Josephson, Mark E.

PY - 1991/8

Y1 - 1991/8

N2 - Background. Many studies have combined patients with hemodynamically well-tolerated ventricular tachycardia (VT) and those with cardiac arrest (CA) as a single, homogenous group. Recent studies suggest that these two groups have different electrophysiological substrates and responses to therapy. Most of these studies, however, enrolled patients with a variety of cardiac diagnoses. Methods and Results. We used signal-averaged electrocardiography (SAECG) and endocardial catheter mapping to define the electrophysiological substrate in patients with coronary artery disease and VT or CA and correlate the results of the two methods. We also examined the usefulness of SAECG in CA patients to differentiate those with inducible arrhythmias from those who are noninducible. VT patients were more likely to have had a prior myocardial infarction (p=0.0005) and to have inducible arrhythmias (p=0.0001) than were CA patients. The induced arrhythmias in patients who presented with VT was VT in more than 90% of cases, whereas in CA patients, polymorphic ventricular tachycardia (PMVT) accounted for one third of induced arrhythmias. Mean filtered QRS duration was longer (135 versus 120 msec) and the terminal QRS voltage was smaller (20 versus 34 μV) in VT than in CA patients (p

AB - Background. Many studies have combined patients with hemodynamically well-tolerated ventricular tachycardia (VT) and those with cardiac arrest (CA) as a single, homogenous group. Recent studies suggest that these two groups have different electrophysiological substrates and responses to therapy. Most of these studies, however, enrolled patients with a variety of cardiac diagnoses. Methods and Results. We used signal-averaged electrocardiography (SAECG) and endocardial catheter mapping to define the electrophysiological substrate in patients with coronary artery disease and VT or CA and correlate the results of the two methods. We also examined the usefulness of SAECG in CA patients to differentiate those with inducible arrhythmias from those who are noninducible. VT patients were more likely to have had a prior myocardial infarction (p=0.0005) and to have inducible arrhythmias (p=0.0001) than were CA patients. The induced arrhythmias in patients who presented with VT was VT in more than 90% of cases, whereas in CA patients, polymorphic ventricular tachycardia (PMVT) accounted for one third of induced arrhythmias. Mean filtered QRS duration was longer (135 versus 120 msec) and the terminal QRS voltage was smaller (20 versus 34 μV) in VT than in CA patients (p

KW - Cardiac arrest

KW - Coronary artery disease

KW - Electrocardiography, signal-averaged

KW - Electrophysiology

KW - Mapping

KW - Ventricular tachycardia

UR - http://www.scopus.com/inward/record.url?scp=0025878542&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025878542&partnerID=8YFLogxK

M3 - Article

C2 - 1860211

AN - SCOPUS:0025878542

VL - 84

SP - 672

EP - 678

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 2

ER -