BlueCross BlueShield of Tennessee Medical Policy Manual

Signal Averaged Electrocardiography (SAECG)


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.  




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.


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

American College of Cardiology. (1996). ACC Expert Consensus Document. Signal-averaged electrocardiography. Retrieved September 7, 2018 from

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. Abstract retrieved November 7, 2016 from PubMed database.

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. Abstract retrieved November 7, 2016 from PubMed database.

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.

Proclemer, A., Lewalter, T., Bongiorni, M.G., Svendsen, J.H., Pison, L., Lundgyist, C.B. (2013). Screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy: results of the European Heart Rhythm Association survey. Europace, 15 (7), 1059-1062. Abstract retrieved September 10, 2018 from PubMed database.

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. Abstract retrieved November 7, 2016 from PubMed database.


MOST RECENT REVIEW DATE:  10/10/2019    


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