PREDICTION OF ARRHYTHMIA RISK-BASED ON SIGNAL-AVERAGED ECG IN POSTINFARCTION PATIENTS

In patients surviving acute MI, identification of those at high risk f or life-threatening ventricular tachyarrhythmias and/or sudden death i s of great importance. Numerous strategies based on indices such as th e degree of left ventricular dysfunction, complex ventricular arrhythm ias, or parameters of autonomic dysfunction have not yet led to an eff ective identification of the individual patient at risk. During the pa st decade, many investigators have recorded low amplitude, high freque ncy components in the terminal QRS complex (so-called late potentials) from patients prone to sustained ventricular tachycardia. The SAECG h as been used to predict life-threatening tachyarrhythmias in patients after acute MI and to screen for inducible ventricular tachycardia in patients with unexplained syncope or sustained ventricular tachycardia . This review article describes the most frequently applied methodolog y and clinical applications of the SAECG in post-MI patients and discu sses the usefulness of noninvasive recordings in various other clinica l settings.