Document Detail


Effects of late (1 to 30 days) reperfusion after acute myocardial infarction on the signal-averaged electrocardiogram.
MedLine Citation:
PMID:  8420230     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early reperfusion (4 to 6 hours) after acute myocardial infarction reduces mortality and reduces the incidence of late potentials on a signal-averaged electrocardiogram (SAECG). Recent reports suggest that reperfusion accomplished after > 6 hours also may reduce mortality. The effect of such later reperfusion on the SAECG is not known. We hypothesized that reperfusion by angioplasty accomplished > 24 hours after onset of infarction would reduce late potentials and improve the parameters on the SAECG. Forty-one patients with a totally occluded infarct-related artery 12 +/- 8 days after infarction underwent attempted angioplasty. SAECG, echocardiography and thallium-201 imaging were performed before and 1 month after attempted angioplasty. Angioplasty resulted in successful reperfusion in 32 patients and was unsuccessful in 9. No change in the incidence of late potentials occurred after successful reperfusion (13 of 32 patients before and 13 of 32 patients 1 month later) or after unsuccessful reperfusion (6 of 9 patients before and 5 of 9 patients 1 month later). Among patients with successful reperfusion, no significant change occurred in the QRS duration or the terminal signal duration < 40 microV. The terminal root-mean-square voltage in microvolts improved significantly at 1 month (31 +/- 25 before to 38 +/- 29 after, p = 0.004). Twenty-two of 32 patients with successful reperfusion had improved wall motion in the infarct zone at 1 month. Despite an improvement in function in these patients, no change in the incidence of late potentials occurred by 1 month.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
M Ragosta; P J Sabia; S Kaul; J P DiMarco; I J Sarembock; E R Powers
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  71     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-02-05     Completed Date:  1993-02-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  19-23     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Virginia School of Medicine, Charlottesville.
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MeSH Terms
Descriptor/Qualifier:
Action Potentials / physiology
Angioplasty, Transluminal, Percutaneous Coronary* / methods
Coronary Circulation / physiology
Coronary Vessels / pathology
Echocardiography
Electrocardiography*
Heart / physiopathology
Humans
Middle Aged
Myocardial Contraction / physiology
Myocardial Infarction / pathology,  physiopathology*,  therapy*
Stroke Volume / physiology
Thallium Radioisotopes / diagnostic use
Time Factors
Vascular Patency
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes

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


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