Prevalence and Prognostic Significance of Late Potentials in Coronary Artery Disease

Ventricular late potantials (LP) occurring after the QRS complex were detected on the body surface using high-resolution ECG and signal-averaging techniques in 14 normal subjects and 62 patients with coronary artery disease (CAD). All patients had a previous myocardial infarction and were not taking antiarrhythmic drugs. In the control subjects no LP were recorded. The prevalence of LP was 34 % in patients with CAD. Among 43 patients without documented ventricular tachycardia and/or fibrillation (VT/VF), LP were present in 9 (21 %), of 19 patients with documented VT/VF 12 (63 %) had LP. The prevalence of LP increased to 77 % (17 of 22) in the presence of ventricular aneurysm or akinesia. During the follow-up period (mean 6.1 months) 7 patients with LP (33 %) presented an episode of sustained VT/VF and 4 of them (19 %) died from documented VT/VF. An episode of VT/VF appeared in only 2 patients (5 %) without LP. We conclude that LP are a frequent finding in patients with regional contraction abnormalities, both in patients with or without documented VT/VF, their presence increases the risk of VT/VF and sudden arrhythmic death.