COMPARISON OF THE NEW ACCELERATION SPECTRUM ANALYSIS WITH OTHER TIME-AND FREQUENCY-DOMAIN ANALYSES OF THE SIGNAL-AVERAGED ELECTROCARDIOGRAM

Aim To compare four analysis techniques of the signal-averaged-electro cardiogram, including time-domain, spectral temporal mapping, spectral turbulence analysis and the new acceleration spectrum analysis. Metho ds and Results We studied 634 subjects (77 with bundle branch block) d ivided into three groups. Group 1 comprised 117 post-myocardial infarc tion patients tested for inducibility of sustained ventricular tachyca rdia, and which was induced in 54 of them. Group 2 comprised 407 conse cutive acute myocardial infarction survivors, followed for 1 year; 29 of them had suffered major arrhythmic events: 15 were cases of sustain ed ventricular tachycardia, three resuscitated ventricular fibrillatio n and 11 sudden cardiac death. Group 3 comprised 110 control subjects. The different analysis techniques were compared by their likelihood r atio for the prediction of ventricular tachycardia inducibility (Group 1) or major arrhythmic events (Group 2). The likelihood ratios of spe ctral-turbulence-analysis, acceleration spectrum analysis, spectral te mporal mapping and time-domain were 8.0, 3.3, 1.7, 1.3 in Group 1, and 3.8, 2.1, 1.5, 2.6, in Group 2, while the corresponding false-positiv e rates in Group 3 (control) were 0.9%, 10.0%, 4.5%, and 3.6%, respect ively. Conclusion Spectral turbulence analysis was the most accurate t echnique for the prediction of either ventricular tachycardia inducibi lity or major arrhythmic events after myocardial infarction. It also s howed the highest specificity among control subjects.