Document Detail

High-frequency QRS electrocardiogram predicts perfusion defects during myocardial perfusion imaging.
MedLine Citation:
PMID:  16387056     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Changes in high-frequency (HF) QRS components of the electrocardiogram (ECG) (150-250 Hz) are more sensitive than changes in conventional ST segments for detecting myocardial ischemia. We investigated the accuracy of 12-lead HF QRS ECG in detecting perfusion defects during adenosine tetrofosmin myocardial perfusion imaging (MPI). METHODS AND RESULTS: 12-lead HF QRS ECG recordings were obtained from 45 patients before and during adenosine technetium Tc 99m tetrofosmin MPI tests. Before the adenosine infusions, recordings of HF QRS were analyzed according to a morphologic score that incorporated the number, type, and location of reduced amplitude zones (RAZs) present in the 12 leads. During the adenosine infusions, recordings of HF QRS were analyzed according to the maximum percentage changes (in both the positive and negative directions) that occurred in root mean square voltage amplitudes within the 12 leads. The best set of prospective HF QRS criteria had a sensitivity of 94% and a specificity of 83% for correctly identifying the MPI result. The sensitivity of simultaneous ST-segment changes (18%) was significantly lower than that of any individual HF QRS criterion (P < .001). CONCLUSIONS: Analysis of 12-lead HF QRS ECG is highly sensitive and reasonably specific for detecting perfusion defects during adenosine MPI stress tests and significantly more sensitive than analysis of conventional ST segments.
M Atiar Rahman; Alex Gedevanishvili; Yochai Birnbaum; Laura Sarmiento; Waralee Sattam; Walter B Kulecz; Todd T Schlegel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2005-11-28
Journal Detail:
Title:  Journal of electrocardiology     Volume:  39     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-02     Completed Date:  2006-04-25     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  73-81     Citation Subset:  IM    
MD Anderson Cancer Center, Houston, TX 77030, USA.
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MeSH Terms
Adenosine / diagnostic use*
Chest Pain / diagnosis
Coronary Circulation / physiology*
Exercise Test
False Positive Reactions
Middle Aged
Myocardial Ischemia / diagnosis*,  physiopathology,  radionuclide imaging
Organophosphorus Compounds / diagnostic use
Organotechnetium Compounds / diagnostic use
Preoperative Care
Radiopharmaceuticals / diagnostic use
Regression Analysis
Sensitivity and Specificity
Signal Processing, Computer-Assisted
Vasodilator Agents / diagnostic use*
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/Vasodilator Agents; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 58-61-7/Adenosine
Comment In:
J Electrocardiol. 2006 Jan;39(1):87   [PMID:  16387058 ]

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

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