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Effects of exercise on the signal-averaged electrocardiogram in coronary artery disease

1990; Elsevier BV; Volume: 66; Issue: 1 Linguagem: Inglês

10.1016/0002-9149(90)90735-j

1879-1913

Edward B. Caref, Nieca Goldberg, Lawrence Mendelson, Gerard L. Hanley, Rachel Okereke, Richard A. Stein, Nabil El‐Sherif,

ECG Monitoring and Analysis

The effects of exercise on the signal-averaged electrocardiogram (SAECG) were investigated in 52 patients with stable coronary artery disease. The SAECG was recorded before and immediately after the exercise test and analyzed at 25 to 250 Hz and 40 to 250 Hz. All patients had SAECG with noise level ≤0.8 μV at 25 Hz and ≤0.6 μV at 40 Hz and with the difference in noise level between control SAECGs and SAECGs after exercise ≤0.2 to 0.3 μV. Twenty-eight patients developed ST changes consistent with transient subendocardial ischemia that persisted during the SAECG recording after exercise. There was no significant difference between control SAECGs and SAECGs after exercise in patients with or without a positive exercise test. The absence of significant change on the SAECG was not related to the presence or absence of prior myocardial infarction, site of infarction, development of exercise-induced ventricular arrhythmias or presence of an abnormal recording at baseline. These data suggest that exercise-induced electrophysiologic changes and ventricular arrhythmias may not be related to the anatomic-electrophysiologic substrate that underlies late potentials on the SAECG.