Frequency-domain analysis of the signal-averaged electrocardiogram in hematological malignancies survivors.

Objectives: The aim of the presented study was to evaluate the frequency-domain signal-averaged ECGs (SAECG) abnormalities in childhood and adolescence acute leukemia and lymphoma survivors treated either with or without anthracyclines (ANT) containing chemotherapy in comparison with healthy volunteers.

Background: The late development of chemotherapy-induced myocardial complications becomes an issue as the number of childhood cancer survivors is increasing. Underlying cardiac impairment may progress to serious cardiac diseases. Therefore, an early identification of myocardial injury is essential. PATIENTS AMD METHODS: Study population was divided into two treatment groups: ANT group (31 patients previously treated with ANT), and non-ANT group (32 patients who underwent chemotherapy without ANT, both more than 5 years ago). SAECG was added to routine cardiology examination in the whole population study and 32 controls. Using the frequency-domain analysis within the QRS complex a ratio (AR) of 20-50 (Hz)/0-20 (Hz) was calculated.

Results: AR 20-50/0-20 in SAECG was significantly higher in ANT and non-ANT groups, relative to controls (262.5 p < 0.00001 vs. 135.9 p < 0.001 vs. 74.7). The difference between both patient groups was also evident p < 0.01.

Conclusion: Significant differences in frequency-domain SAECG parameters between patients (with or without anthracyclines) and controls might indicate the increased risk of electrical instability particularly in anthracycline-treated patients (Tab. 2, Fig. 1, Ref. 34).