Document Detail


Continuous ST-segment monitoring of patients with left bundle branch block and suspicion of acute myocardial infarction.
MedLine Citation:
PMID:  15078499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Patients with left bundle branch block comprise 5-9% of all patients with acute myocardial infarction. Limited data exist on the usefulness of continuous electrocardiographic monitoring of these patients. We have investigated prospectively the usefulness of real-time continuous vectorcardiography for monitoring patients with left bundle branch block and suspicion of acute myocardial infarction. DESIGN: A prospective multi-centre study. SETTING: Fourteen Swedish coronary care units. SUBJECTS: Patients with left bundle branch block and suspicion of acute myocardial infarction with <6-h symptom duration were included. MAIN OUTCOME MEASURES: All patients were monitored with continuous vectorcardiography for 12-24 h. RESULTS: One hundred thirty-three patients were included, 47% had acute myocardial infarction. Patients with acute myocardial infarction showed a marked relative decrease in ST-vector than those without (P = 0.0002). These changes were most marked in the first 90 min. When comparing patients with acute myocardial infarction receiving thrombolytic therapy or not, those treated with thrombolytics showed more marked decline in ST-vector magnitude (P < 0.0001) and in shorter time (P = 0.0017). All patients showed STC-vector magnitude changes that were more marked in patients with acute myocardial infarction (P = 0.0002). An STC-vector magnitude cut-off value of 65 microV after 90 min of monitoring gave 54% sensitivity and 72% specificity for diagnosis of acute myocardial infarction. CONCLUSION: Real-time continuous vectorcardiographic monitoring of patients with left bundle branch and suspicion of acute myocardial infarction shows significant differences between those with and without acute myocardial infarction and could be of use for early diagnosis and subsequent monitoring.
Authors:
G Gunnarsson; P Eriksson; M Dellborg
Related Documents :
961589 - Intraventricular trifascicular block verified by his bundle electrocardiography.
2760649 - Locked-in state in borrelia burgdorferi meningitis.
3883929 - Ventricular exclusion during fontan operation: an evolving technique.
9121959 - Transient right bundle branch block causing r wave attenuation postdefibrillation.
7832099 - Cardiac conduction system involvement in sudden death of obese young people.
881609 - Cardiac abnormalities in a female patient with hypogonadotropic hypogonadism with anosmia.
778359 - Morphological changes in indefinitely surviving enhanced ectopic rat cardiac allografts.
16008149 - The zwolle global experience on primary percutaneous coronary intervention.
15576339 - Gated myocardial perfusion spect: basic principles, technical aspects, and clinical app...
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of internal medicine     Volume:  255     ISSN:  0954-6820     ISO Abbreviation:  J. Intern. Med.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-13     Completed Date:  2004-05-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  571-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Akureyri Regional Hospital, V/Eyrarlandsveg, 600 Akureyri, Iceland. gunnarg@fsa.is
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bundle-Branch Block / complications*
Female
Humans
Male
Middle Aged
Monitoring, Physiologic / methods
Myocardial Infarction / complications*,  diagnosis*
Prospective Studies
Sensitivity and Specificity
Vectorcardiography / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Cost-effectiveness of clopidogrel in acute coronary syndromes in Sweden: a long-term model based on ...
Next Document:  Rapid Emergency Medicine score: a new prognostic tool for in-hospital mortality in nonsurgical emerg...