TY - JOUR
T1 - Early ischemic ST-segment and T-wave changes during balloon angioplasty
AU - Pessah, Mazal Anna
AU - Huhtala, Heini
AU - Kosonen, Petteri
AU - Eskola, Markku
AU - Pérez-Riera, Andrés Ricardo
AU - Nikus, Kjell
AU - Rankinen, Jani
N1 - Funding Information:
The study was supported by an unrestricted grant from MSD Finland and by grants from the Finnish Cultural Foundation , Special Governmental Subsidy , and Finnish Medical Foundation .
Publisher Copyright:
© 2022 The Authors
PY - 2022
Y1 - 2022
N2 - Background: Acute coronary occlusion results in increased T-wave amplitude and ST-segment elevation in the ECG leads facing the ischemic region. Material and methods: We performed continuous ECG recording in 34 patients during balloon occlusion of the left anterior descending (LAD), left circumflex (LCx) and right coronary artery (RCA). Delta (Δ) ST and ΔT amplitudes were calculated by subtracting the preinflation values from the values measured during balloon inflation. Results: Occlusion of the LAD resulted in greater increase in the amplitude of the T wave than of the ST segment in lead V2 (ΔT +3.4 mm, inter-quartile range [IQR] 1—6 mm; ΔST +1.4 mm, 0.5—3 mm). During RCA occlusion, ΔST and ΔT didn't differ significantly. LCx occlusion resulted in significant differences between ΔST and ΔT in all leads, except aVF and V3-V4. In two patients (LCx), we observed a biphasic ST-T response: an initial negative change of the T-wave amplitude was followed by a positive change in leads V1-V2. In leads II, III, aVF and V4-V6, there was an initial positive change, followed by a final negative change towards the end of the occlusion. Conclusion: Continuous 12‑lead ECG recording during balloon occlusion of the LCx resulted in significant differences between the ΔST and ΔT values in all leads except aVF and V3-V4. LAD and RCA occlusion resulted in less evident differences between the ST-segment and T-wave changes. A change in polarity of T-wave changes during balloon occlusion (initial negative and final positive change, or vice versa) proved to be a rare finding.
AB - Background: Acute coronary occlusion results in increased T-wave amplitude and ST-segment elevation in the ECG leads facing the ischemic region. Material and methods: We performed continuous ECG recording in 34 patients during balloon occlusion of the left anterior descending (LAD), left circumflex (LCx) and right coronary artery (RCA). Delta (Δ) ST and ΔT amplitudes were calculated by subtracting the preinflation values from the values measured during balloon inflation. Results: Occlusion of the LAD resulted in greater increase in the amplitude of the T wave than of the ST segment in lead V2 (ΔT +3.4 mm, inter-quartile range [IQR] 1—6 mm; ΔST +1.4 mm, 0.5—3 mm). During RCA occlusion, ΔST and ΔT didn't differ significantly. LCx occlusion resulted in significant differences between ΔST and ΔT in all leads, except aVF and V3-V4. In two patients (LCx), we observed a biphasic ST-T response: an initial negative change of the T-wave amplitude was followed by a positive change in leads V1-V2. In leads II, III, aVF and V4-V6, there was an initial positive change, followed by a final negative change towards the end of the occlusion. Conclusion: Continuous 12‑lead ECG recording during balloon occlusion of the LCx resulted in significant differences between the ΔST and ΔT values in all leads except aVF and V3-V4. LAD and RCA occlusion resulted in less evident differences between the ST-segment and T-wave changes. A change in polarity of T-wave changes during balloon occlusion (initial negative and final positive change, or vice versa) proved to be a rare finding.
KW - Balloon angioplasty
KW - ECG
KW - Myocardial ischemia
KW - ST changes
KW - T wave
U2 - 10.1016/j.jelectrocard.2022.06.003
DO - 10.1016/j.jelectrocard.2022.06.003
M3 - Article
AN - SCOPUS:85132503527
SN - 0022-0736
VL - 73
SP - 87
EP - 95
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
ER -