Comparison of reproducibility of conventional and signal-averaged electrocardiography

Objective. The aim of our study was to compare the reproducibility of signal-averaged and conventional electrocardiogram (ECG).

Design and methods. The study group included 20 young healthy volunteers (10 men and 10 women, aged 18–25 years) examined twice with one-week interval. Twelve-lead and Frank’s orthogonal system ECG recordings were acquired during 5 minutes using computerized ECG device at each examination; conventional and averaged ECG analyses were performed. Mathematical processing to get averaged ECG in each lead was performed using original program «HR ECG». The sum of P wave, PQ interval, and QRS durations and the sum of P, Q, R, S, T waves amplitudes (amplitudes) in lead I of 12‑lead ECG and in lead Y in Frank’s lead system and left ventricular hypertrophy (LVH) indices (Sokolow-Lyon, Cornell voltage, Cornell product) were used for the evaluation of reproducibility.

Results. Variation coefficients of durations between two evaluations of conventional and signal-averaged ECG were 13,1 % versus 4,8 % (p < 0,01) for lead I and 16 % versus 4,8 % (p < 0,01) for lead Y, respectively. Variation coefficients of amplitudes between two examinations of conventional and signal-averaged ECG were 12,2 % versus 7,2 % (p < 0,01) for lead I and 10,3 % versus 6,7 % for lead Y (p < 0,05), respectively. Variation coefficients of Sokolow-Lyon index, Cornell voltage and Cornell product were 12,3; 16,9 и 12,8 % versus 8,0; 14,2 и 10,1 %, respectively (p < 0,05 for all variables).

Conclusions. The reproducibility of the signalaveraged ECG is significantly higher than the conventional one for interval duration, wave amplitude, as well as for LVH indices. The use of this method in clinical practice will increase the reliability of individual evaluation of myocardial changes at single examination and during follow-up. In studies with ECG control it may contribute to the decrease in study duration or group size required to reach statistically significant differences.

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