This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Abboud, S. Articles by Friedman, P. L. Search for Related Content PubMed PubMed Citation Articles by Abboud, S. Articles by Friedman, P. L. Pubmed/NCBI databases Medline Plus Health Information Angioplasty

Circulation, Vol 76, 585-596, Copyright © 1987 by American Heart Association

ARTICLES

Detection of transient myocardial ischemia by computer analysis of standard and signal-averaged high-frequency electrocardiograms in patients undergoing percutaneous transluminal coronary angioplasty

S Abboud, RJ Cohen, A Selwyn, P Ganz, D Sadeh and PL Friedman

Electrocardiographic manifestations of transient myocardial ischemia were studied, in 11 patients undergoing angioplasty (PTCA) of a left anterior descending coronary artery stenosis, by the visual inspection of the standard surface electrocardiogram (S-ECG) and the intracoronary ECG (IC-ECG) as well as computer-assisted analysis of the S-ECG. Cross- correlation analysis (CCA) performed by computer was used to compare beat-to-beat variability in ST-T morphology of the S-ECG during different stages of PTCA. CCA was also applied to the signal-averaged high-frequency QRS (SA-HFQ). All patients developed angina during balloon inflation, accompanied by transient marked ST-T changes in IC- ECG in 10 of 11 patients (90%). Visual inspection of S-ECG revealed transient ST-T changes in only 6 of 11 (54%). In contrast, CCA of the S- ECG revealed transient ST-T changes in 9 of 11 (82%). Analysis of SA- HFQ revealed that balloon inflation was associated with a marked reduction in the calculated root-mean-square (RMS) voltage for such signals (2.31 +/- 1.04 microV) as compared with RMS values before (3.27 +/- 1.12 microV, p less than .05) PTCA or after conclusion of PTCA (3.79 +/- 1.39 microV, p less than .01). Balloon inflation was also accompanied by changes in waveform morphology of the SA-HFQ, including the development of new or more prominent time zones of reduced amplitude in 10 of 11 individuals (90%). Such zones may represent slow conduction in regions of the heart rendered ischemic during PTCA. CCA of the S-ECG and of SA-HFQ appears to detect evidence of transient ischemia with greater sensitivity than simple visual inspection of S- ECG, and may therefore prove to be of use in the evaluation of patients with chest pain of uncertain origin.

This article has been cited by other articles:

				N. Herring and D.J. Paterson ECG diagnosis of acute ischaemia and infarction: past, present and future QJM, April 1, 2006; 99(4): 219 - 230. [Full Text] [PDF]

				T. N. Spackman, M. D. Abel, and T. T. Schlegel Twelve-Lead High-Frequency QRS Electrocardiography During Anesthesia in Healthy Subjects Anesth. Analg., April 1, 2005; 100(4): 1043 - 1047. [Abstract] [Full Text] [PDF]

				T. T. Schlegel, W. B. Kulecz, J. L. Depalma, A. H. Feiveson, J. S. Wilson, M. A. Rahman, and M. W. Bungo Real-Time 12-Lead High-Frequency QRS Electrocardiography for Enhanced Detection of Myocardial Ischemia and Coronary Artery Disease Mayo Clin. Proc., March 1, 2004; 79(3): 339 - 350. [Abstract] [PDF]

				J. Pettersson, O. Pahlm, E. Carro, L. Edenbrandt, M. Ringborn, L. Sornmo, S. G. Warren, and G. S. Wagner Changes in high-frequency QRS components are more sensitive than ST-segment deviation for detecting acute coronary artery occlusion J. Am. Coll. Cardiol., November 15, 2000; 36(6): 1827 - 1834. [Abstract] [Full Text] [PDF]

				P. Steinbigler, R. Haberl, C. Jeleazcov, A. Knez, U. Dorwarth, D. Muller, E. Hoffmann, and G. Steinbeck Functional changes of ventricular late potentials by provocation with increase of heart rate: Evaluation during atrial pacing Europace, January 1, 1999; 1(2): 103 - 112. [Abstract] [PDF]

				P. Lander, P. Gomis, R. Goyal, E. J. Berbari, P. Caminal, R. Lazzara, and J. S. Steinberg Analysis of Abnormal Intra-QRS Potentials : Improved Predictive Value for Arrhythmic Events With the Signal-Averaged Electrocardiogram Circulation, March 18, 1997; 95(6): 1386 - 1393. [Abstract] [Full Text]