Sudden cardiac death: the search for a non-invasive means to detect the electrical substrate for the development of life-threatening XXXX .

@entity1 @entity1165 @entity65 @entity943 @entity204
@entity65 remain the major cause of @entity204 in the adult North American population. Most of these @entity204 are sudden, occurring secondary to @entity1165 /fibrillation (VT/VF). Based on the results of recent clinical trials, it seems likely that many of these @entity204 could be prevented if reliable means were available to select those @entity1 at highest risk. To date, however, no totally satisfactory means to establish risk has been identified. The purpose of this paper is to review the currently utilized techniques and to draw attention to some new and potentially useful technology involving computer processing of surface recorded electrocardiographic (ECG) signals. ECG monitoring during rest and activity is neither sensitive nor specific. Invasive studies, using programmed ventricular stimulation to reproduce clinical @entity943 , have proven extremely useful in the management of @entity1 with recurrent VT/VF; this technique allows the selection of effective therapy as documented by subsequent inability to induce the @entity943 . However, this technique does not have broad applicability given the complexity of these studies and the significant potential for morbidity. Recent efforts have focused on the detection of the abnormal electrical substrate giving rise to VT/VF by using body-surface electrocardiographic recording. Two approaches are being investigated. In one, high-gain, signal-averaged ECG signals are being utilized to detect (delayed) depolarization potentials occurring during the repolarization process - an electrophysiologic state known to give rise to re-entrant @entity943 . Initial results with this technique are encouraging. We have focused on another approach - that of body-surface potential mapping.(ABSTRACT TRUNCATED AT 250 WORDS)
