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The Signal-Averaged ECG: Clinical Applications

  • J. Anthony GomesEmail author
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Abstract

Although the standard ECG provides substantial information on cardiac electrical activity, it fails to record signals in the microvolt range. Signal averaging technique enables recording and identification of low amplitude signals by improving the signal-to-noise ratio. Thus, the signal-averaged ECG (SAECG) was initially used for noninvasive recording of His bundle potential and subsequently to detect “late potentials” (LPs) for risk assessment for sudden cardiac death (SCD) and/or VT in various clinical settings. However, the initial enthusiasm for the SAECG waned following the results of the MADIT-II Trial that opted the use of ejection fraction (EF) as the main risk stratifying modality. In this chapter, the role of the SAECG in other conditions such as infiltrative heart disease, right ventricular dysplasia, evaluation of syncope, tetralogy of Fallot-associated VT, the Brugada syndrome, post-ablation of VT, and atrial fibrillation is discussed.

Keywords

Signal-averaged ECG Heart rate variability T wave alternans Fragmented QRS complex Cardiac sarcoidosis Chagas disease Amyloidosis Syncope Tetralogy of Fallot 

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Icahn School of MedicineMount Sinai HospitalNew YorkUSA

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