Document Detail

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.
MedLine Citation:
PMID:  1960317     Owner:  NLM     Status:  MEDLINE    
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.
A E Weyne; M L De Buyzere; F R Bauwens; D L Clement
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
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:
Created Date:  1992-01-03     Completed Date:  1992-01-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1704-10     Citation Subset:  AIM; IM    
Department of Cardiology, University Hospital of Gent, Belgium.
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MeSH Terms
Angina Pectoris / etiology*
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Coronary Disease / complications,  diagnosis*,  epidemiology
Electrocardiography / instrumentation,  methods,  standards*
Evaluation Studies as Topic
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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