Signal averaging of pre- and post-extrasystolic beats in patients with ventricular arrhythmias

To evaluate the effects of premature ventricular beats on the impulse conduction of adjacent sinus cycles, we compared the high amplification signal-averaged electrocardiogram parameters of the pre- and post-extrasystolic beats with those of the remaining sinus cycle. According to the duration of filtered QRS (fQRS), to the voltage of root mean square of the terminal 40 ms (RMS 40) and to the duration of low amplitude terminal components of the sinus cycles, ventricular late potentials were detected in nine out of 29 subjects. Patients with an abnormal signal-averaged electrocardiogram exhibited a longer fQRS (146 ± 6 versus 116 ± 2 ms), a reduced RMS40 voltage (18 ± 2 versus 80 ± 10 μV) and a prolonged duration of <40 μV components (42 ± 4 versus 17± 2 ms). Analysis of the pre-extrasystolic beats did not reveal any signifcant variation in the above parameters, showing a mean difference of 0.44 ± 2.4 ms; 0.02 ± 1.14 μV; 1 ± 1.9 ms and of -1.45 ± 1.02 ms; 3.5 ± 8.6 μV; -0.7 ± 0.84 ms respectively, for patients with and without ventricular late potentials. In addition, no significant variation was observed when the post-extrasystolic beats were considered. These results indicate that the sinus cycles adjacent to premature ventricular discharges do not present variations of signal-averaged electrocardiogram parameters that may suggest an influence of the ectopic beats on their intramyocardial inmpulse propagation.