Comparison of wavelet continuous transform and signal averaged ECG for high frequency content and late potential detection in healthy individuals

Introduction The Signal Averaged ECG (SAECG) is a classical method forSudden Cardiac Death (SCD) risk assessment, by means of Late Potentials (LP) in the filtered QRS (fQRS)[1]. But it is highly dependent on noise and require long time records, which make it tedious to use. Wavelet Continuous Transform (WCT) meanwhile is easier to use, and may let us to measure the High Frequency Content (HFC) of the QRS and QT intervals, which also correlates with the risk of SCD [2,3]. Whether the HFC of the QRS and QT measured with the WCT is a possible subrogate of LP, has never been demonstrated. Objective To demonstrate if there is any relationship between the HFC measured with the WCT and the LP analyzed with the SAECG. Methods Data from 50 consecutive healthy individuals. The standard ECG was digitally collected for 3 consecutive minutes. For the WCT Analysis 8 consecutive QT complexes were used and for the SAECG Analysis all available QRS were used. The time-frequency data of each QT complex were collected using the WCT as previously described [3] and the Total, QRS and QT power were obtained from each patient. For the SAECG, bipolar X, Y and Z leads were used with a bidirectional filter at 40 to 250 Hz [1]. LP were defined as less than 0.05 z in the terminal part of the filtered QRS and the duration (SAECG LP duration) and root mean square (SAECG LP Content) of this LP were calculated. Pearson's test was used to correlate the Power content with WCT analysis and the LP in the SAECG. Results There is a strong correlation between Total Power and the SAECG LP content (r=0.621, p<0.001). Both ST Power (r=0.567, p<0.001) and QRS Power (r=0.404, p=0.004) are related with the SAECG LP content. No correlation were found between the Power content (Total, QRS or ST Power) and the SAECG LP duration. Also no correlation was found between de SAECG LP content and duration. Conclusions Total, QRS and ST Power measured with the WCT are good surrogates of SAECG LP content. No correlation were found between WCT analysis and the SAECG LP duration. Also no correlation was found between the SAECG LP content and duration. This can be of high interest, since WCT is an easier technique, not needing long recordings and being less affected by noise. Funding Acknowledgement Type of funding source: None