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Small, high-frequency electrocardiographic signals were recorded from the body surface in 39 patients with and 27 patients without ventricular tachycardia (VT). All patients were in normal sinus rhythm, had a previous myocardial infarction, were not taking antiarrhythmic drugs, and did not have bundle branch block. Bipolar X, Y, Z leads were signal averaged and processed by a bidirectional digital filter that allowed low-amplitude signals to be detected in the terminal QRS complex and ST segment. The high-pass filter frequency was 25 Hz. Patients with VT had a lower amplitude of high-frequency signal in the late QRS complex. In the last 40 msec of the filtered QRS complex, the patients with VT had 14.9 +/- 14.4 microV of high-frequency signal; patients without VT had 73.8 +/- 47.7 microV (p less than 0.0001). Ninety-two percent of the patients with VT had less than 25 microV of high-frequency voltage; only 7% of patients without VT had less than 25 microV (p less than 0.0001). Patients with VT had a longer QRS duration than those without VT, 139 +/- 26 vs 95 +/- 10 msec (p less than 0.0001). The QRS duration was longer than 120 msec in 72% of the patients with VT but in none of the patients without VT (p less than 0.0001). In all patients there was no separate and discrete high-frequency signal in the ST segment. Advanced signal processing of the ECG accurately identified the patients in the study with VT after myocardial infarction.

Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction.