Relationship between the occurrence of late potential on the body surface ECG and cardiac performance in myocardial infarction.

Comparative evaluations of the percent of the perimetric circumference of infarction and cardiac performance for the occurrence of late potential were performed in 12 normal subjects and 22 patients with old myocardial infarction (MI). All patients were in normal sinus rhythm without bundle branch block. Bipolar X, Y, and Z leads were signal-averaged using a bandpass filter with a low-cut frequency of 100 Hz and a high-cut frequency of 300 Hz. The filtered signals for the three leads were displayed and combined into a vector magnitude, square root of X2 + Y2 + Z2. The percent ratio of the root mean square voltage in the last 40 msec of the QRS complex was calculated against that of the total filtered QRS (%RMS40). The value of the standard deviation (SD) in the phase distribution was obtained by the Fourier analysis of multi-gated blood pool images. Significant differences were observed among MI with late potential, MI without it and the normal subjects for %RMS 40 (5.7 +- 2.8% vs 26.9 +- 8.1, 37.5 +- 10.8%). Left ventricular ejection fraction was lower in MI with late potential (19.7 +- 7%) compared to that of MI without it (33 +- 18%) and the normal subjects (60 +- 4%); the value of SD was higher in MI with late potential (64 +- 21 degrees), compared to that of MI without it (43 +- 20 degrees) and the normal subjects (9 +- 4 degrees). These findings showed that the percent ratio of the last 40 msec RMS voltage (%RMS 40) was found to discriminate effectively among MI with and without late potential and normal subjects. It was suggested that the amount and structure of the infarcts may be important factors in the occurrence of late potential.