Abstract | BACKGROUND: Patients with the combination of bundle-branch block and ischemic heart disease have a poor outcome. There is no established criterion for detection of transient ischemia when bundle-branch block is present. OBJECTIVE: To elucidate vectorcardiographic changes during coronary angioplasty of patients with bundle-branch block. DESIGN AND METHODS: The QRS complex and ST-segment changes of 29 patients with bundle-branch block were studied during elective coronary angioplasty using continuous vectorcardiography. Data for the patients with bundle-branch block were compared with data for narrow-QRS-complex controls, matched for the vessel dilated, sex, and age. RESULTS: Patients with bundle-branch block were found to have more pronounced changes in the QRS-vector difference as a response to coronary occlusion than did controls. ST-vector magnitude responded in a similar way during coronary occlusion of patients with and without bundle-branch block but from different baselines. ST change-vector magnitude was found to be the most sensitive parameter for detection of ischemia in patients with bundle-branch block as well as for controls. CONCLUSION: Monitoring of transient ischemia during coronary angioplasty for patients with bundle-branch block is feasible using continuous vectorcardiography. A change in ST vector magnitude > 100 microV is suggested to indicate significant ischemia in the presence of bundle-branch block.
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Authors | P Eriksson, P Albertsson, L Ekström, M Dellborg |
Journal | Coronary artery disease
(Coron Artery Dis)
Vol. 10
Issue 7
Pg. 501-7
(Oct 1999)
ISSN: 0954-6928 [Print] England |
PMID | 10562918
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Aged
- Angioplasty, Balloon, Coronary
(methods)
- Bundle-Branch Block
(physiopathology)
- Female
- Humans
- Lown-Ganong-Levine Syndrome
(physiopathology)
- Male
- Middle Aged
- Monitoring, Intraoperative
(methods)
- Myocardial Ischemia
(physiopathology)
- Sensitivity and Specificity
- Tachycardia, Sinus
(physiopathology)
- Vectorcardiography
(methods)
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