Key result
Endocardial late potentials were detected in 90% of patients, occurring more frequently in coronary heart disease (50 of 52) than in dilative cardiomyopathy (26 of 34; p<0.025).
Why the study?
Does left ventricular endocardial mapping reveal different incidences of late potentials in patients with coronary heart disease versus dilative cardiomyopathy?
Observational (n=100)
Does left ventricular endocardial mapping reveal different incidences of late potentials in patients with coronary heart disease versus dilative cardiomyopathy?
Absolute Event Rate: 96.2% vs 76.5%
p-value: p=<0.025
Endocardial late potentials are common in various cardiac diseases, with a higher frequency and more fractionated electrograms in coronary heart disease compared to dilative cardiomyopathy, suggesting inhomogeneous fibrosis.
Late potentials differ by etiology; hypothesis-generating for fibrosis patterns and should not yet change mapping practice.
In a prospective study, 100 patients with various cardiac diseases not selected on the basis of previous ventricular arrhythmias underwent left ventricular endocardial mapping. With 10 different positions of the quadripolar catheter per patient, 90 of the 100 patients showed late potentials. These findings were documented in 50 of 52 patients with coronary heart disease compared to 26 of 34 patients with dilative cardiomyopathy (p less than 0.025). Late potentials in diastole were the most frequent type of abnormal electrogram, found in 82 patients. Fractionated electrograms were documented in 43 patients. They were seen in 27 (52%) coronary patients more often than in 8 (24%) patients with dilative cardiomyopathy (p less than 0.025). Onset of fractionated electrograms in coronary patients was somewhat later (301 +/- 177 ms after the QRS) than in the cardiomyopathy group (263 +/- 141 ms). The duration was longer (189 +/- 114 ms) in the former group than in the latter (148 +/- 87 ms). Thus, endocardial late potentials are not uncommon in patients with various cardiac diseases. The more frequent occurrence in coronary heart disease and the higher frequency of fractionated electrograms may indicate a more inhomogeneous, patchy type of fibrosis in the ischemically diseased myocardium.
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Bethge et al. (1988) conducted an observational in Various cardiac diseases (n=100). Left ventricular endocardial mapping vs. Dilative cardiomyopathy (disease state comparison) was evaluated on Incidence of late potentials (p=<0.025). Endocardial late potentials were detected in 90% of patients, occurring more frequently in coronary heart disease (50 of 52) than in dilative cardiomyopathy (26 of 34; p<0.025).
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