Document Detail

The delayed activation wave in non-ST-elevation myocardial infarction.
MedLine Citation:
PMID:  21663984     Owner:  NLM     Status:  Publisher    
BACKGROUND: Little is known about the relationship between the electrocardiographic characteristics and the infarct related artery (IRA) in non-ST-elevation myocardial infarction (NSTEMI). We found a curious phenomenon in electrocardiograms of patients with acute occlusion of left circumflex artery in NSTEM: A notch or deflection was often present in the terminal QRS complex in leads II,III and aVF or I,aVL . The objective of this study was to determine whether the previously unreported ECG phenomenon that we have found in NSTEMI could identify the culprit artery in non-ST-elevation myocardial infarction. METHODS AND RESULTS: Our study included 218 NSTEMI patients who presented to our institution and underwent coronary angiography within 24 hours of admission. For convenience, 'N' wave was defined as a notch or deflection in the terminal QRS complex of the surface ECG. The duration of QRS with N wave before PCI was more prolonged than the duration of QRS without N wave (121±12ms vs 106±11ms, P<0.01). In the LCX group, 66(77%) patients had N wave in leads II, III and aVF, whereas only 5(6%) patients in the LAD group and 9(18%) patients in the RCA group had such ECG feature (P<0.001). A greater proportion of patients in the LCX group also had N waves in leads I and aVL (P<0.001). N wave in leads II, III and aVF was associated with 77% sensitivity and 89% specificity, respectively. N wave in leads I and aVL was associated with 64% sensitivity and 96% specificity, respectively. CONCLUSION: The abnormal waveform in terminal QRS complex in NSTEMI ,which is described above, is the delayed activation wave of left ventricular basal region which the left circumflex artery supplies. It is associated with a higher specificity and higher sensitivity for culprit LCX in non-ST-elevation myocardial infarction. The delayed activation wave is a new pattern of ischemia in ECG.
Tiesheng Niu; Peng Fu; Chenhong Jia; Yaling Dong; Chunyu Liang; Qian Cao; Zhiyong Yang; Rao Fu; Xingang Zhang; Zhaoqing Sun
Related Documents :
22886964 - Effect of minocycline postconditioning and ischemic postconditioning on myocardial isch...
21686234 - Pai-1 antagonists: the promise and the peril.
10940954 - Psychosocial factors as predictors of functional status at 1 year in patients with left...
22395114 - Role of metalloproteinases and tissue inhibitors of metalloproteinases during cardiopul...
7358204 - Comparison of action of beta-methyldigoxin and digoxin utilizing systolic time intervals.
7296554 - Human myocardial morphologic and functional changes in the first 24 hours after doxorub...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-8
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  Predicting 30-day major adverse cardiovascular events after primary percutaneous coronary interventi...
Next Document:  Cardiac remodeling induced by 13-cis retinoic acid treatment in acne patients.