Evaluation of arrhythmic causes of syncope: Correlation between holter monitoring, electrophysiologic testing, and body surface potential mapping
Identifieur interne : 001858 ( Istex/Corpus ); précédent : 001857; suivant : 001859Evaluation of arrhythmic causes of syncope: Correlation between holter monitoring, electrophysiologic testing, and body surface potential mapping
Auteurs : Dominique Lacroix ; Marc Dubuc ; Teresa Kus ; Pierre Savard ; Mohammad Shenasa ; Réginald NadeauSource :
- American Heart Journal [ 0002-8703 ] ; 1991.
Abstract
Holter monitoring, electrocardiographic (ECG) signal-averaging, body surface potential mapping (BSPM) for PQRST isoarea maps, and electrophysiologic study (EPS) were performed in 100 patients with syncope. Coronary artery disease (CAD) was found in 46 patients and other heart disease was found in 19. EPS was diagnostic in 44 patients, while Holter monitoring suggested a diagnosis in only 21 patients. Abnormal BSPM was frequently seen (56%), especially in CAD (70%), or with inducible ventricular tachycardia (VT) (87%). Late potentials were recorded in 13 patients with CAD; five had inducible VT. In seven other patients with VT, they were either absent or bundle branch block (BBB) was found. Thirteen deaths (three sudden) occurred in our series. EPS-guided therapy resulted in a low rate of total cardiac death. In conclusion, EPS had a higher diagnostic yield than Holter monitoring regardless of cardiac pathology. ECG signal-averaging was useful in predicting VT only in patients with CAD without BBB. BSPM was abnormal in most patients with cardiac disease, but poorly predicted VT.
Url:
DOI: 10.1016/0002-8703(91)90576-4
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type="doi">10.1016/0002-8703(91)90576-4</idno><idno type="url">https://api-v5.istex.fr/document/8C5CC029AF229B67B8BCB3B7CA29D1B89C5041A8/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001858</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001858</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Evaluation of arrhythmic causes of syncope: Correlation between holter monitoring, electrophysiologic testing, and body surface potential mapping</title><author><name sortKey="Lacroix, Dominique" sort="Lacroix, Dominique" uniqKey="Lacroix D" first="Dominique" last="Lacroix">Dominique Lacroix</name><affiliation><mods:affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation></author><author><name sortKey="Dubuc, Marc" sort="Dubuc, Marc" uniqKey="Dubuc M" first="Marc" last="Dubuc">Marc Dubuc</name><affiliation><mods:affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation></author><author><name sortKey="Kus, Teresa" sort="Kus, Teresa" uniqKey="Kus T" first="Teresa" last="Kus">Teresa Kus</name><affiliation><mods:affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation></author><author><name sortKey="Savard, Pierre" sort="Savard, Pierre" uniqKey="Savard P" first="Pierre" last="Savard">Pierre Savard</name><affiliation><mods:affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation></author><author><name sortKey="Shenasa, Mohammad" sort="Shenasa, Mohammad" uniqKey="Shenasa M" first="Mohammad" last="Shenasa">Mohammad Shenasa</name><affiliation><mods:affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation></author><author><name sortKey="Nadeau, Reginald" sort="Nadeau, Reginald" uniqKey="Nadeau R" first="Réginald" last="Nadeau">Réginald Nadeau</name><affiliation><mods:affiliation>Reprint requests: R. Nadeau, MD, Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Blvd. West, Montreal, Québec, Canada H4J 1C5.</mods:affiliation></affiliation><affiliation><mods:affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">American Heart Journal</title><title level="j" type="abbrev">YMHJ</title><idno type="ISSN">0002-8703</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1991">1991</date><biblScope unit="volume">122</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="1346">1346</biblScope><biblScope unit="page" to="1354">1354</biblScope></imprint><idno type="ISSN">0002-8703</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-8703</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Holter monitoring, electrocardiographic (ECG) signal-averaging, body surface potential mapping (BSPM) for PQRST isoarea maps, and electrophysiologic study (EPS) were performed in 100 patients with syncope. Coronary artery disease (CAD) was found in 46 patients and other heart disease was found in 19. EPS was diagnostic in 44 patients, while Holter monitoring suggested a diagnosis in only 21 patients. Abnormal BSPM was frequently seen (56%), especially in CAD (70%), or with inducible ventricular tachycardia (VT) (87%). Late potentials were recorded in 13 patients with CAD; five had inducible VT. In seven other patients with VT, they were either absent or bundle branch block (BBB) was found. Thirteen deaths (three sudden) occurred in our series. EPS-guided therapy resulted in a low rate of total cardiac death. In conclusion, EPS had a higher diagnostic yield than Holter monitoring regardless of cardiac pathology. ECG signal-averaging was useful in predicting VT only in patients with CAD without BBB. BSPM was abnormal in most patients with cardiac disease, but poorly predicted VT.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Dominique Lacroix MD</name><affiliations><json:string>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</json:string><json:string>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string></affiliations></json:item><json:item><name>Marc Dubuc MD</name><affiliations><json:string>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</json:string><json:string>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string></affiliations></json:item><json:item><name>Teresa Kus MD, PhD</name><affiliations><json:string>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</json:string><json:string>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string></affiliations></json:item><json:item><name>Pierre Savard PhD</name><affiliations><json:string>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</json:string><json:string>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string></affiliations></json:item><json:item><name>Mohammad Shenasa MD</name><affiliations><json:string>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</json:string><json:string>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string></affiliations></json:item><json:item><name>Réginald Nadeau MD</name><affiliations><json:string>Reprint requests: R. Nadeau, MD, Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Blvd. West, Montreal, Québec, Canada H4J 1C5.</json:string><json:string>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</json:string><json:string>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string><json:string>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Clinical investigations</value></json:item></subject><articleId><json:string>91905764</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>Holter monitoring, electrocardiographic (ECG) signal-averaging, body surface potential mapping (BSPM) for PQRST isoarea maps, and electrophysiologic study (EPS) were performed in 100 patients with syncope. Coronary artery disease (CAD) was found in 46 patients and other heart disease was found in 19. EPS was diagnostic in 44 patients, while Holter monitoring suggested a diagnosis in only 21 patients. Abnormal BSPM was frequently seen (56%), especially in CAD (70%), or with inducible ventricular tachycardia (VT) (87%). Late potentials were recorded in 13 patients with CAD; five had inducible VT. In seven other patients with VT, they were either absent or bundle branch block (BBB) was found. Thirteen deaths (three sudden) occurred in our series. EPS-guided therapy resulted in a low rate of total cardiac death. In conclusion, EPS had a higher diagnostic yield than Holter monitoring regardless of cardiac pathology. ECG signal-averaging was useful in predicting VT only in patients with CAD without BBB. 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Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Pierre</forename><surname>Savard</surname></persName><roleName type="degree">PhD</roleName><affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</affiliation><affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Mohammad</forename><surname>Shenasa</surname></persName><roleName type="degree">MD</roleName><affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</affiliation><affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Réginald</forename><surname>Nadeau</surname></persName><roleName type="degree">MD</roleName><affiliation>Reprint requests: R. Nadeau, MD, Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Blvd. West, Montreal, Québec, Canada H4J 1C5.</affiliation><affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</affiliation><affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation></author><idno type="istex">8C5CC029AF229B67B8BCB3B7CA29D1B89C5041A8</idno><idno type="DOI">10.1016/0002-8703(91)90576-4</idno><idno type="PII">0002-8703(91)90576-4</idno><idno type="ArticleID">91905764</idno></analytic><monogr><title level="j">American Heart Journal</title><title level="j" type="abbrev">YMHJ</title><idno type="pISSN">0002-8703</idno><idno type="PII">S0002-8703(00)X0105-6</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1991"></date><biblScope unit="volume">122</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="1346">1346</biblScope><biblScope unit="page" to="1354">1354</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1991</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Holter monitoring, electrocardiographic (ECG) signal-averaging, body surface potential mapping (BSPM) for PQRST isoarea maps, and electrophysiologic study (EPS) were performed in 100 patients with syncope. Coronary artery disease (CAD) was found in 46 patients and other heart disease was found in 19. EPS was diagnostic in 44 patients, while Holter monitoring suggested a diagnosis in only 21 patients. Abnormal BSPM was frequently seen (56%), especially in CAD (70%), or with inducible ventricular tachycardia (VT) (87%). Late potentials were recorded in 13 patients with CAD; five had inducible VT. In seven other patients with VT, they were either absent or bundle branch block (BBB) was found. Thirteen deaths (three sudden) occurred in our series. EPS-guided therapy resulted in a low rate of total cardiac death. In conclusion, EPS had a higher diagnostic yield than Holter monitoring regardless of cardiac pathology. ECG signal-averaging was useful in predicting VT only in patients with CAD without BBB. BSPM was abnormal in most patients with cardiac disease, but poorly predicted VT.</p></abstract><textClass><keywords scheme="keyword"><list><head>article-category</head><item><term>Clinical investigations</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1991">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api-v5.istex.fr/document/8C5CC029AF229B67B8BCB3B7CA29D1B89C5041A8/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>YMHJ</jid><aid>91905764</aid><ce:pii>0002-8703(91)90576-4</ce:pii><ce:doi>10.1016/0002-8703(91)90576-4</ce:doi><ce:copyright type="unknown" year="1991"></ce:copyright><ce:doctopics><ce:doctopic><ce:text>Clinical investigations</ce:text></ce:doctopic></ce:doctopics></item-info><head><ce:title>Evaluation of arrhythmic causes of syncope: Correlation between holter monitoring, electrophysiologic testing, and body surface potential mapping</ce:title><ce:author-group><ce:author><ce:given-name>Dominique</ce:given-name><ce:surname>Lacroix</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Marc</ce:given-name><ce:surname>Dubuc</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Teresa</ce:given-name><ce:surname>Kus</ce:surname><ce:degrees>MD, PhD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Pierre</ce:given-name><ce:surname>Savard</ce:surname><ce:degrees>PhD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Mohammad</ce:given-name><ce:surname>Shenasa</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Réginald</ce:given-name><ce:surname>Nadeau</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>a</ce:label><ce:textfn>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>b</ce:label><ce:textfn>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</ce:textfn></ce:affiliation><ce:affiliation id="AFF3"><ce:label>c</ce:label><ce:textfn>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</ce:textfn></ce:affiliation><ce:affiliation id="AFF4"><ce:label>d</ce:label><ce:textfn>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Reprint requests: R. Nadeau, MD, Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Blvd. West, Montreal, Québec, Canada H4J 1C5.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="5" month="4" year="1991"></ce:date-received><ce:date-accepted day="3" month="6" year="1991"></ce:date-accepted><ce:abstract class="author"><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">Holter monitoring, electrocardiographic (ECG) signal-averaging, body surface potential mapping (BSPM) for PQRST isoarea maps, and electrophysiologic study (EPS) were performed in 100 patients with syncope. Coronary artery disease (CAD) was found in 46 patients and other heart disease was found in 19. EPS was diagnostic in 44 patients, while Holter monitoring suggested a diagnosis in only 21 patients. Abnormal BSPM was frequently seen (56%), especially in CAD (70%), or with inducible ventricular tachycardia (VT) (87%). Late potentials were recorded in 13 patients with CAD; five had inducible VT. In seven other patients with VT, they were either absent or bundle branch block (BBB) was found. Thirteen deaths (three sudden) occurred in our series. EPS-guided therapy resulted in a low rate of total cardiac death. In conclusion, EPS had a higher diagnostic yield than Holter monitoring regardless of cardiac pathology. ECG signal-averaging was useful in predicting VT only in patients with CAD without BBB. BSPM was abnormal in most patients with cardiac disease, but poorly predicted VT.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Evaluation of arrhythmic causes of syncope: Correlation between holter monitoring, electrophysiologic testing, and body surface potential mapping</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Evaluation of arrhythmic causes of syncope: Correlation between holter monitoring, electrophysiologic testing, and body surface potential mapping</title></titleInfo><name type="personal"><namePart type="given">Dominique</namePart><namePart type="family">Lacroix</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</affiliation><affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marc</namePart><namePart type="family">Dubuc</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</affiliation><affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Teresa</namePart><namePart type="family">Kus</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</affiliation><affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pierre</namePart><namePart type="family">Savard</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</affiliation><affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mohammad</namePart><namePart type="family">Shenasa</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</affiliation><affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Réginald</namePart><namePart type="family">Nadeau</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Reprint requests: R. Nadeau, MD, Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Blvd. West, Montreal, Québec, Canada H4J 1C5.</affiliation><affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada</affiliation><affiliation>Department of Medicine, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Department of Pharmacology, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><affiliation>Institut de Génie Biomédical, Faculty of Medicine, Université de Montréal Montréal, Québec, Canada.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1991</dateIssued><copyrightDate encoding="w3cdtf">1991</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Holter monitoring, electrocardiographic (ECG) signal-averaging, body surface potential mapping (BSPM) for PQRST isoarea maps, and electrophysiologic study (EPS) were performed in 100 patients with syncope. Coronary artery disease (CAD) was found in 46 patients and other heart disease was found in 19. EPS was diagnostic in 44 patients, while Holter monitoring suggested a diagnosis in only 21 patients. Abnormal BSPM was frequently seen (56%), especially in CAD (70%), or with inducible ventricular tachycardia (VT) (87%). Late potentials were recorded in 13 patients with CAD; five had inducible VT. In seven other patients with VT, they were either absent or bundle branch block (BBB) was found. Thirteen deaths (three sudden) occurred in our series. EPS-guided therapy resulted in a low rate of total cardiac death. In conclusion, EPS had a higher diagnostic yield than Holter monitoring regardless of cardiac pathology. ECG signal-averaging was useful in predicting VT only in patients with CAD without BBB. BSPM was abnormal in most patients with cardiac disease, but poorly predicted VT.</abstract><subject><genre>article-category</genre><topic>Clinical investigations</topic></subject><relatedItem type="host"><titleInfo><title>American Heart Journal</title></titleInfo><titleInfo type="abbreviated"><title>YMHJ</title></titleInfo><genre type="journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">199111</dateIssued></originInfo><identifier type="ISSN">0002-8703</identifier><identifier type="PII">S0002-8703(00)X0105-6</identifier><part><date>199111</date><detail type="volume"><number>122</number><caption>vol.</caption></detail><detail type="issue"><number>5</number><caption>no.</caption></detail><extent unit="issue pages"><start>A25</start><end>A28</end></extent><extent unit="issue pages"><start>A3</start><end>A20</end></extent><extent unit="issue pages"><start>A35</start><end>A36</end></extent><extent unit="issue pages"><start>1239</start><end>1502</end></extent><extent unit="pages"><start>1346</start><end>1354</end></extent></part></relatedItem><identifier type="istex">8C5CC029AF229B67B8BCB3B7CA29D1B89C5041A8</identifier><identifier type="DOI">10.1016/0002-8703(91)90576-4</identifier><identifier type="PII">0002-8703(91)90576-4</identifier><identifier type="ArticleID">91905764</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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