加算平均心電図の再現性に関する検討
加算平均心電図による心室遅延電位検出の診断結果の再現性につき検討した. まず本邦で使用頻度の高いVCM-3000とART1200EPXを用い, 機器による差の有無を検討した. 健常成人50例を対象に記録間隔10分間で時間解析法 (TDM) を行い, 2記録間の自動診断一致率を比較したところ, 前者で80%・後者で92%であり, 後者のほうが再現性に優れていた. このART1200EPXを用い健常者20例において, 10分後ならびに1週間後の再現性をTDM, および周波数解析法 (FFT) で検討した. 両法とも個々のパラメーターの値は記録毎に変動したが, 心室遅延電位の診断一致率は, TDMで...
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| Published in | 順天堂医学 Vol. 41; no. 4; pp. 455 - 465 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
順天堂医学会
1996
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0022-6769 2188-2134 |
| DOI | 10.14789/pjmj.41.455 |
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| Abstract | 加算平均心電図による心室遅延電位検出の診断結果の再現性につき検討した. まず本邦で使用頻度の高いVCM-3000とART1200EPXを用い, 機器による差の有無を検討した. 健常成人50例を対象に記録間隔10分間で時間解析法 (TDM) を行い, 2記録間の自動診断一致率を比較したところ, 前者で80%・後者で92%であり, 後者のほうが再現性に優れていた. このART1200EPXを用い健常者20例において, 10分後ならびに1週間後の再現性をTDM, および周波数解析法 (FFT) で検討した. 両法とも個々のパラメーターの値は記録毎に変動したが, 心室遅延電位の診断一致率は, TDMでは10分間および1週間の記録間隔ともに90%, FFTでは両間隔ともに100%と, 両法とも良好な再現性を示した. 以上の成績をふまえ, 健常者50例および心筋梗塞症例42例を対象に記録間隔10分間で同様の検討を行った. 健常群の診断一致率はTDMで92%・FFTで100%であり, 心筋梗塞群ではTDMで93%・FFTで90%と両法ともに良好な再現性を示した. 以上のように, 加算平均心電図によって測定した各パラメーターの値は記録毎に変動を示すが, 最終的な診断結果は両法ともに虚血性心疾患の有無にかかわらず良好な再現性を示した. |
|---|---|
| AbstractList | 加算平均心電図による心室遅延電位検出の診断結果の再現性につき検討した. まず本邦で使用頻度の高いVCM-3000とART1200EPXを用い, 機器による差の有無を検討した. 健常成人50例を対象に記録間隔10分間で時間解析法 (TDM) を行い, 2記録間の自動診断一致率を比較したところ, 前者で80%・後者で92%であり, 後者のほうが再現性に優れていた. このART1200EPXを用い健常者20例において, 10分後ならびに1週間後の再現性をTDM, および周波数解析法 (FFT) で検討した. 両法とも個々のパラメーターの値は記録毎に変動したが, 心室遅延電位の診断一致率は, TDMでは10分間および1週間の記録間隔ともに90%, FFTでは両間隔ともに100%と, 両法とも良好な再現性を示した. 以上の成績をふまえ, 健常者50例および心筋梗塞症例42例を対象に記録間隔10分間で同様の検討を行った. 健常群の診断一致率はTDMで92%・FFTで100%であり, 心筋梗塞群ではTDMで93%・FFTで90%と両法ともに良好な再現性を示した. 以上のように, 加算平均心電図によって測定した各パラメーターの値は記録毎に変動を示すが, 最終的な診断結果は両法ともに虚血性心疾患の有無にかかわらず良好な再現性を示した. |
| Author | 大野, 安彦 |
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| References | 6) 小沢友紀雄: Late Potential. 心臓ペーシング, 5: 285-317, 1989 10) BreithardtG, CainME, El-sherifN, et al.: Standards for Analysis of Ventricular Late Potentials Using High-Resolution or Signal-Averaged Electrocardiography: A Statement by a Task Force Committee of the European society of Cardiology, the American Heart Association, and the American College of Cardiology. J Am Coll Cardiol, 17: 999-1006, 1991 5) BuckinghamTA, GhoshS, HomanSM, et al.: Independent Value of Signal-Averaged Electrocardiography and Left Ventricular Function in Identifying Patients with Sustained Ventricular Tachycardia with Coronary Artery Disease. Am J Cardiol, 59: 568-572, 1987 22) 中里祐二, 岩享, Fontaine, G: 加算平均心電図における各種解析法の評価について. 心臓, 25 (Supp1): 94-100, 1993 13) EngelDR, PierceDL, MurphySP: Variation in Late Potentials and the Reproducibility of their Measurement. Progress in Cardiovascular Diseases, 35: 247-262, 1993 25) TimmermansC, EctorH, HaistyKW, et al.: Signal-Averaged ECG Parameters in Cardiac Normals Using Frank Lead System and Fourier Transform Filter and Gender Specific Differences: A Multiple Study. PACE, 17: 303-311, 1994 4) OzawaY, YakuboS, TanigawaN, et al.: The Clinical Evaluation of the Late Potentials in Patients with Ventricular Arrhythmias. Jpn Circ J, 51: 230-241, 1987 17) SagerPT, WiderhornJ, PascualM, et al.: A prospective evaluation of the immediate reproducibility of the signal-averaged ECG. Am Heart J, 121: 1671-1678, 1991 15) KucharDL, ThorburnCW, SammelNL: Late potentials detected after myocardial infarction: natural history and prognostic significance. Circulation, 74: 1280-1289, 1986 20) DennissAR, RossDL, UtherJB: Reproducibility of Measurements of Ventricular Activation Time Using the Signal-Averaged Frank Vectorcardiogram. Am J Cardiol, 57: 156-160, 1986 21) MalikM, KulakowskiP, PolonieckiJ, et al.: Frequency Versus Time Domain Analysis of Signal-Averaged Electrocardiograms. I. Reproducibility of the Results. J Am Coll Cardiol, 20: 127-134, 1992 3) GomesJA, WintersSL, MartinsonM, et al.: The Prognostic Significance of Quantitative Signal-Averaged Variables Relative to Clinical Variables, Site of Myocardial Infarction, Ejection Fraction and Ventricular Premature Beats: A Prospective Study. J Am Coll Cardiol, 13: 377-384, 1989 19) DenesP, SantarelliP, HauserRG, et al.: Quantitative Analysis of the High-frequency Components of the Terminal Portion of the Body Surface QRS in Normal Subjects and in Patients with Ventricular Tachycardia. Circulation, 67: 1129-1138, 1983 23) 中里祐二, 岩享, Fontaine, G: 非虚血性心室頻拍患者同定のための周波数解析法の有用性について. 心電図, 13: 208-217, 1993 2) RozanskiJJ, MortaraD, MyerburgRJ, et al.: Body Surface Detection of Delayed Depolarization in Patients with Recurrent Ventricular Tachycardia and Left Ventricular Aneurysm. Circulation, 63: 1172-1178, 1981 24) LanderP, BerbariEJ, RajagopalanCV, et al.: Critical Analysis of the Signal-Averaged Electrocardiogram: Improved Identification of Late Potentials. Circulation, 87: 105-117, 1993 16) GrimmM, BillhardtRA, MayerhoferKE, et al.: Prognostic Significance of Signal-averaged ECGs During Acute Myocardial Infarction: A Preliminary Report. J Electrocardiol, 21: 283-288, 1988 14) LewisSJ, LanderPT, TaylorPA, et al.: Evaluation of Late Potential Activity in the First Six Weeks After Acute Myocardial Infarction. Am J Cardiol, 63: 647-651, 1989 8) LindsayBD, AmbosHD, SchechtmanKB, et al.: Improved Differentiation of Patients With and Without Ventricular Tachycardia by Frequency Analysis of Multiple Electrocardiographic Leads. Am J Cardiol, 62: 556-561, 1988 12) HenkinR, CarefEB, KelenGJ, et al.: The Signal-averaged Electrocardiogram and Late Potential: A Comparative Analysis of Commercial Devices. J Electrocardiol, 22 (Suppl): 19-24, 1989 9) LindsayBD, MarkhamJ, SchechtmanKB, et al.: Identification of patients with sustained ventricular tachycardia by frequency analysis of signal-averaged electrocardiograms despite the presence of bundle branch block. Circulation, 77: 122-130, 1988 1) SimsonMB: Use of Signal in the Terminal QRS Complex to Identify Patients with Ventricular Tachycardia After Myocardial Infarction. Circulation, 64: 235-242, 1981 18) BorbolaJ, DenesP: Short-and Long-Term Reproducibility of the Signal-Averaged Electrocardiogram in Coronary Artery Disease. Am J Cardiol, 61: 1123-1124, 1988 11) VacekJL, SmithS, DunnMI: Late Potential Parameter and Noise Level Variability Caused by Bandpass Versus High-Pass Filtering and Type of Signal Averaging Equipment Used. J Electrophysiol, 3: 278-282, 1989 7) GomesJA, WintersSL, StewartD, et al.: Optimal Bandpass Filter for Time-Domain Analysis of the Signal-Averaged Electrocardiogram. Am J Cardiol, 60: 1290-1296, 1987 |
| References_xml | – reference: 13) EngelDR, PierceDL, MurphySP: Variation in Late Potentials and the Reproducibility of their Measurement. Progress in Cardiovascular Diseases, 35: 247-262, 1993 – reference: 21) MalikM, KulakowskiP, PolonieckiJ, et al.: Frequency Versus Time Domain Analysis of Signal-Averaged Electrocardiograms. I. Reproducibility of the Results. J Am Coll Cardiol, 20: 127-134, 1992 – reference: 22) 中里祐二, 岩享, Fontaine, G: 加算平均心電図における各種解析法の評価について. 心臓, 25 (Supp1): 94-100, 1993 – reference: 23) 中里祐二, 岩享, Fontaine, G: 非虚血性心室頻拍患者同定のための周波数解析法の有用性について. 心電図, 13: 208-217, 1993 – reference: 3) GomesJA, WintersSL, MartinsonM, et al.: The Prognostic Significance of Quantitative Signal-Averaged Variables Relative to Clinical Variables, Site of Myocardial Infarction, Ejection Fraction and Ventricular Premature Beats: A Prospective Study. J Am Coll Cardiol, 13: 377-384, 1989 – reference: 11) VacekJL, SmithS, DunnMI: Late Potential Parameter and Noise Level Variability Caused by Bandpass Versus High-Pass Filtering and Type of Signal Averaging Equipment Used. J Electrophysiol, 3: 278-282, 1989 – reference: 24) LanderP, BerbariEJ, RajagopalanCV, et al.: Critical Analysis of the Signal-Averaged Electrocardiogram: Improved Identification of Late Potentials. Circulation, 87: 105-117, 1993 – reference: 5) BuckinghamTA, GhoshS, HomanSM, et al.: Independent Value of Signal-Averaged Electrocardiography and Left Ventricular Function in Identifying Patients with Sustained Ventricular Tachycardia with Coronary Artery Disease. Am J Cardiol, 59: 568-572, 1987 – reference: 16) GrimmM, BillhardtRA, MayerhoferKE, et al.: Prognostic Significance of Signal-averaged ECGs During Acute Myocardial Infarction: A Preliminary Report. J Electrocardiol, 21: 283-288, 1988 – reference: 7) GomesJA, WintersSL, StewartD, et al.: Optimal Bandpass Filter for Time-Domain Analysis of the Signal-Averaged Electrocardiogram. Am J Cardiol, 60: 1290-1296, 1987 – reference: 14) LewisSJ, LanderPT, TaylorPA, et al.: Evaluation of Late Potential Activity in the First Six Weeks After Acute Myocardial Infarction. Am J Cardiol, 63: 647-651, 1989 – reference: 19) DenesP, SantarelliP, HauserRG, et al.: Quantitative Analysis of the High-frequency Components of the Terminal Portion of the Body Surface QRS in Normal Subjects and in Patients with Ventricular Tachycardia. Circulation, 67: 1129-1138, 1983 – reference: 9) LindsayBD, MarkhamJ, SchechtmanKB, et al.: Identification of patients with sustained ventricular tachycardia by frequency analysis of signal-averaged electrocardiograms despite the presence of bundle branch block. Circulation, 77: 122-130, 1988 – reference: 12) HenkinR, CarefEB, KelenGJ, et al.: The Signal-averaged Electrocardiogram and Late Potential: A Comparative Analysis of Commercial Devices. J Electrocardiol, 22 (Suppl): 19-24, 1989 – reference: 10) BreithardtG, CainME, El-sherifN, et al.: Standards for Analysis of Ventricular Late Potentials Using High-Resolution or Signal-Averaged Electrocardiography: A Statement by a Task Force Committee of the European society of Cardiology, the American Heart Association, and the American College of Cardiology. J Am Coll Cardiol, 17: 999-1006, 1991 – reference: 17) SagerPT, WiderhornJ, PascualM, et al.: A prospective evaluation of the immediate reproducibility of the signal-averaged ECG. Am Heart J, 121: 1671-1678, 1991 – reference: 25) TimmermansC, EctorH, HaistyKW, et al.: Signal-Averaged ECG Parameters in Cardiac Normals Using Frank Lead System and Fourier Transform Filter and Gender Specific Differences: A Multiple Study. PACE, 17: 303-311, 1994 – reference: 15) KucharDL, ThorburnCW, SammelNL: Late potentials detected after myocardial infarction: natural history and prognostic significance. Circulation, 74: 1280-1289, 1986 – reference: 8) LindsayBD, AmbosHD, SchechtmanKB, et al.: Improved Differentiation of Patients With and Without Ventricular Tachycardia by Frequency Analysis of Multiple Electrocardiographic Leads. Am J Cardiol, 62: 556-561, 1988 – reference: 1) SimsonMB: Use of Signal in the Terminal QRS Complex to Identify Patients with Ventricular Tachycardia After Myocardial Infarction. Circulation, 64: 235-242, 1981 – reference: 18) BorbolaJ, DenesP: Short-and Long-Term Reproducibility of the Signal-Averaged Electrocardiogram in Coronary Artery Disease. Am J Cardiol, 61: 1123-1124, 1988 – reference: 4) OzawaY, YakuboS, TanigawaN, et al.: The Clinical Evaluation of the Late Potentials in Patients with Ventricular Arrhythmias. Jpn Circ J, 51: 230-241, 1987 – reference: 2) RozanskiJJ, MortaraD, MyerburgRJ, et al.: Body Surface Detection of Delayed Depolarization in Patients with Recurrent Ventricular Tachycardia and Left Ventricular Aneurysm. Circulation, 63: 1172-1178, 1981 – reference: 6) 小沢友紀雄: Late Potential. 心臓ペーシング, 5: 285-317, 1989 – reference: 20) DennissAR, RossDL, UtherJB: Reproducibility of Measurements of Ventricular Activation Time Using the Signal-Averaged Frank Vectorcardiogram. Am J Cardiol, 57: 156-160, 1986 |
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| Snippet | 加算平均心電図による心室遅延電位検出の診断結果の再現性につき検討した. まず本邦で使用頻度の高いVCM-3000とART1200EPXを用い, 機器による差の有無を検討した. 健常成... |
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| SubjectTerms | 再現性 加算平均心電図 心室遅延電位 |
| Title | 加算平均心電図の再現性に関する検討 |
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