Key result
Ventricular late potentials had a lower incidence in idiopathic dilated cardiomyopathy (23%) than in coronary artery disease (34%, P<0.05), and showed low sensitivity for future arrhythmic events.
Why the study?
Does the detection of ventricular late potentials by SAECG predict serious arrhythmic events differently in patients with idiopathic dilated cardiomyopathy compared to those with coronary artery disease?
Cohort (n=300)
Does the detection of ventricular late potentials by SAECG predict serious arrhythmic events differently in patients with idiopathic dilated cardiomyopathy compared to those with coronary artery disease?
Absolute Event Rate: 23% vs 34%
p-value: p=< 0.05
Signal-averaged ECG detection of ventricular late potentials has low sensitivity and positive predictive value for predicting serious arrhythmic events in idiopathic dilated cardiomyopathy, limiting its clinical utility in this population compared to post-infarct patients.
Limits SAECG utility for arrhythmic risk stratification in idiopathic dilated cardiomyopathy; leaves open its incremental value versus standard predictors in nonischemic cohorts.
Objective: This prospective study was designed to compare incidence and clinical significance of ventricular late potentials between patients with idiopathic dilated cardiomyopathy (IDC) and postinfarct patients (CAD) using exactly the same method of signal‐averaged electrocardiography (SAECG) in both patient groups. Methods: Time‐domain analysis of SAECG was performed in 120 consecutive patients with IDC, 120 patients with CAD, and 60 healthy controls. Ventricular late potentials were detected in 27 of 120 patients with IDC (23%) compared to 41 of 120 patients with CAD (34%; P < 0.05). Results: Ventricular late potentials were found in 2 of 60 controls (3%). During 15 ± 7 months follow‐up, serious arrhythmic events occurred in 17 of 120 patients with IDC (14%) and in 13 of 120 patients with CAD (11%). The sensitivity of ventricular late potentials for future arrhythmic events was 35% for IDC compared to 77% for CAD (P < 0.05). The positive predictive value of late potentials detected by time‐domain analysis was 22% for IDC versus 24% for CAD (P = ns). Conclusion: In this selected patient population with IDC and CAD, time‐domain analysis of SAECG revealed a lower incidence of ventricular ate potentials in patients with IDC as compared to postinfarct patients. Whereas ventricular late potentials had a high sensitivity but a low positive predictive value for identification of postinfarct patients with serious arrhythmic events during follow‐up, both sensitivity and positive predictive value of ventricular late potentials for future serious arrhythmic events were low in the setting of IDC.
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Grimm et al. (1997) conducted a cohort in Idiopathic dilated cardiomyopathy and coronary artery disease (n=300). Idiopathic dilated cardiomyopathy vs. Coronary artery disease was evaluated on Incidence of ventricular late potentials (p=< 0.05). Ventricular late potentials had a lower incidence in idiopathic dilated cardiomyopathy (23%) than in coronary artery disease (34%, P<0.05), and showed low sensitivity for future arrhythmic events.
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