High-Resolution Electrocardiography [antikvár]

PrefaceHigh-resolution electrocardiography (HRE) is a technique that allows detection and analysis of low-amplitude electrocardiographic signals that may not be detected on the body surface by routine measurements. The term "signal-averaged electrocardiogram," which is frequently used synonymously with HRE, refers to one signal processing technique that enhances the detection of low-amplitude electrocardiographic signals. Interest in HRE started in the early 1970s, and the goal was to record the His-Purkinje signal noninvasively. Interest in the technique would probably have waned if it was not for the observation made in the mid-70s by El-Sherif, Scherlag, and Lazzara that low-amplitude "fractionated" diastolic potentials are a potential marker for the anatomic-electrophysi-ologic substrate of reentrant arrhythmias. Although this was shown in an experimental model of ischemia, the clinical counterpart of this observation was later made by a number of clinical investigators and these potentials were called "late potentials." The 1980s witnessed an expanded interest in the theoretical, technical, and clinical aspects of HRE.This book is intended to provide a state-of-the-art review of HRE. The book is organized into six separate sections. Theoretical and technical principles of HRE are discussed in detail in the first section. The second section reviews the data on beat-to-beat recordings of HRE, a potentially powerful technique but one that is still in need of further technical refinement before it is introduced to routine clinical use. The electrophysiologic principles of late potentials and their clinical application to risk stratification for arrhythmic events in the post-infarction period are extensively discussed in theix