| Assessment of myocardial ischemia by 12-lead electrocardiography and Frank vector system during coronary angioplasty: value of a new orthogonal lead system for quantitative ST segment monitoring. | |
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MedLine Citation:
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PMID: 1960317 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The optimal number and placement of electrocardiographic (ECG) leads to detect myocardial ischemia induced by coronary balloon inflation was assessed by analyzing ST segment changes in the standard 12-lead ECG and Frank X, Y, Z leads at 90-s intervals during 34 consecutive coronary angioplasty procedures. Mean occlusion time during angioplasty was 218 +/- 65 s. Myocardial ischemia, defined as transient angina or ST segment deviation greater than or equal to 1 mm in at least one lead, occurred in 33 (97%) of the 34 procedures. The most sensitive single leads (V2 or V3) detected 17 (51%) of 33 ischemic episodes. The best dual-lead combinations (leads V2 and V5, leads a VF and V3 and leads V3 and Y) increased the sensitivity of 69% (23 of 33). The three-lead combination V2, V5, Y had the highest detecting power (78% [26 of 33]). The X, Y, Z leads by themselves had a sensitivity of only 60% (20 of 33). From this proposed orthogonal lead system (V2, V5, Y), which combines anteroposterior (V2), left to right (V5) and inferosuperior (Y) forces, the spatial ST vector magnitude was calculated and monitored during balloon inflations. A good correlation was observed between this ST vector magnitude and the sum of ST deviations on the standard ECG (r = 0.940, p less than 0.00001), and these data were reproducible over sequential balloon inflations. The results of the study suggest that this orthogonal lead system is of considerable value in the detection and quantification of acute myocardial ischemia and, in this respect, is more useful than the Frank orthogonal vector system. |
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Authors:
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A E Weyne; M L De Buyzere; F R Bauwens; D L Clement |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 18 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1991 Dec |
Date Detail:
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Created Date: 1992-01-03 Completed Date: 1992-01-03 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1704-10 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, University Hospital of Gent, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angina Pectoris / etiology* Angioplasty, Transluminal, Percutaneous Coronary / adverse effects* Coronary Disease / complications, diagnosis*, epidemiology Electrocardiography / instrumentation, methods, standards* Evaluation Studies as Topic Female Humans Male Middle Aged Monitoring, Physiologic / instrumentation, methods, standards* Reproducibility of Results Sensitivity and Specificity Vectorcardiography / instrumentation, methods, standards* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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