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Time domain analysis (TD) of the signal-averaged electrocardiogram (SAECG) presents a higher incidence of false positives in inferior myocardial infarction (MI), whereas spectral turbulence analysis (STA) suffers from a higher incidence of false positives in anterior MI. We investigated the hypothesis that a combined TD and STA (TD+STA) analysis of the SAECG could improve its predictive accuracy for major arrhythmic events (MAE) after MI.

Signal-averaged electrocardiograms were prospectively recorded 10.1+-2.6 days after acute MI in 602 patients. Time domain analysis and STA were performed using standard parameters and criteria for abnormality. For the combined TD+STA model, stepwise discriminant analysis was utilized to optimize prediction of MAE. Receiver operating characteristic curves were utilized to optimize cutoff values for each SAECG parameter separately, and …