The effect of signal averaging on the reproducibility and reliability of measures of T-wave morphology

Journal of Electrocardiology
Bjorn H BatdorfTodd T Schlegel

Abstract

Electrocardiographic repolarization abnormalities characterized by T-wave morphology parameters such as the principal component analysis ratio and the relative and the absolute T-wave residuum (TWR(rel) and TWR(abs)) are predictive of cardiovascular and/or all-cause mortality. However, when using a "10-second median beat" for analysis, the reported mean values for TWR(rel) vary widely and parameter reproducibility is somewhat suspect. In repeated electrocardiographic recordings conducted 1 month and 1 year apart on 15 and 27 healthy individuals, respectively, we studied the said T-wave morphology parameters in single complexes and in reduced noise signal averages containing 10 and 200 complexes. Considering all subjects, the mean (+/-SD) TWR(rel) was highest in a single complex (0.0345% +/- 0.0183%), intermediate in the 10-beat signal-averaged complexes (0.0125% +/- 0.0051%), and lowest in the 200-beat signal-averaged complexes (0.0078% +/- 0.0036%) (P < .0001), with the same trend also observed in the TWR(abs) but not in the principal component analysis ratio. Reproducibility as quantified by within-subject variance and reliability as quantified by the intraclass (intrasubject) correlation coefficient also improved as the numb...Continue Reading

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Citations

Mar 6, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Paul J SheridanRichard H Clayton
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Aug 22, 2006·Journal of Electrocardiology·Vito Starc, Todd T Schlegel
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Jun 20, 2017·Medical & Biological Engineering & Computing·Salah Al-ZaitiRobert Lux
May 20, 2021·Future Cardiology·Patrick A GladdingTodd T Schlegel

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