Document Detail

ST segment elevation in one lead: a case report.
MedLine Citation:
PMID:  22537334     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We describe an unusual finding in an electrocardiogram showing ST-segment elevation not related to coronary artery stenosis, pericarditis, bundle branch block, or other well known disorders.
CASE PRESENTATION: A 60-year-old African American woman admitted for elective coronary artery bypass graft surgery. A temporary pacemaker with pacing wires was placed intraoperatively for prevention and treatment of postoperative bradyarrhythmia. One day following uneventful surgery, her electrocardiogram demonstrated marked ST segment elevation confined to lead V(6). These changes were comparable to tracings obtained from direct epicardial electrocardiogram, due to contact between the V(6) electrode and the temporary pacemaker ventricular lead wire.
CONCLUSION: Current-of-injury patterns are represented on surface electrocardiogram by deviations of the ST segment from the isoelectric baseline. The pacing wire causes direct localized epicardial current-of-injury, affecting the action potential and the resting membrane potentials of cardiomyocytes. Our case report demonstrates epicardial current-of-injury pattern obtained via surface rather than epicardial electrocardiogram, with surface leads as surrogates of epicardial tracing. Measurement of ST-segment shifts from the epicardial electrocardiogram has been shown to provide a more sensitive measurement of ischemia when compared to surface precordial ECG.
Luay Rifai; Muhyaldeen Dia
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  17     ISSN:  1542-474X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-27     Completed Date:  2012-08-14     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-2     Citation Subset:  IM    
Copyright Information:
© 2012, Wiley Periodicals, Inc.
Department of Internal Medicine, University of Illinois in Chicago/Advocate Christ Medical Center, Oak Lawn, USA.
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MeSH Terms
Action Potentials / physiology
Bradycardia / prevention & control
Cardiac Pacing, Artificial
Coronary Artery Bypass
Electrocardiography / adverse effects*
Membrane Potentials / physiology
Middle Aged
Pacemaker, Artificial / adverse effects*
Comment In:
Ann Noninvasive Electrocardiol. 2013 May;18(3):304   [PMID:  23714092 ]

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

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