Signal Averaged Electrocardiography (SAECG)
DESCRIPTION
Signal-averaged electrocardiography (SAECG) has been proposed as a test to predict which individuals are at highest risk of experiencing an arrhythmic event (either a sustained arrhythmia or sudden cardiac death). Because sudden cardiac death, whether from arrhythmias or pump failure, is one of the most common causes of death after a previous myocardial infarction, there is intense interest in risk stratification to determine target therapy. SAECG involves computerized analysis of small segments of a standard ECG to detect abnormalities. Signals are first amplified, then filtered, and finally averaged with the assistance of computer software.
POLICY
Signal-averaged electrocardiography is considered investigational.
IMPORTANT REMINDERS
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ADDITIONAL INFORMATION
The available literature does not validate the use of SAECG for predicting which individuals are at highest risk of experiencing an arrhythmic event. No trials were found in which use of SAECG was shown to improve outcomes.
SOURCES
American College of Cardiology, American Heart Association Task Force, Heart Rhythm Society. (2017). 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Retrieved September 7, 2018 from www.acc.org.
American College of Cardiology. (1996). ACC Expert Consensus Document. Signal-averaged electrocardiography. Retrieved September 7, 2018 from www.acc.org.
Jongman, J. K., Zaidi, A., Muggenthaler, M. & Sharma, S. (2015). Relationship between echocardiographic right-ventricular dimensions and signal-averaged electrocardiogram abnormalities in endurance athletes. Europace, 17 (9), 1441-1448. (Level 4 evidence)
Kanzaki, Y., Inden, Y., Ando, M., Kamikubo, Y., Ito, T., Mizutani, Y., et al. (2016). An ECG index of P-wave force predicts the recurrence of atrial fibrillation after pulmonary vein isolation. Pacing Clinical Electrophysiology, 39 (11), 1191-1197. Abstract retrieved October 4, 2017 from PubMed database.
Mendes, V. N., Pereira, T. S., & Matos, V. A. (2016). Diagnosis of rejection by analyzing ventricular late potentials in heart transplant patients. Arquivos Brasileiros de Cardiologia, 106 (2), 136-144. (Level 4 evidence)
Pandey, A. K.., Das, A., Singwala, A. K. & Bhatt, K. N. (2010). Prediction and stratification of the future cardiovascular arrhythmic events: signal averaged electrocardiography versus ejection fraction. Indian Journal of Physiology and Pharmacology, 54 (2), 123-132. Abstract retrieved December 3, 2015 from PubMed database.
Suwita, C.S., Nasution, S.A., Muhadi, M., & Kurniawan, J. (2020). Effects of extracardiac factors in signal-averaged electrocardiography-measured late potentials from early anterior myocardial infarction in intensive cardiac care unit. Acta Medica Indonesiana, 52 (2), 131-139. (Level 5 evidence)
Yodogawa, K., Seino, Y., Ohara, T., Hayashi, M., Miyauchi, Y., Katoh, T., et al. (2013). Prediction of atrial fibrillation after ischemic stroke using P-wave signal averaged electrocardiography. Journal of Cardiology, 61 (1), 49-52. (Level 4 evidence)
ORIGINAL EFFECTIVE DATE: 7/1986
MOST RECENT REVIEW DATE: 12/14/2023
ID_BT
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