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Continuous vectorcardiographic monitoring of ischemia during coronary angioplasty in patients with bundle-branch block.

AbstractBACKGROUND:
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.
AuthorsP Eriksson, P Albertsson, L Ekström, M Dellborg
JournalCoronary artery disease (Coron Artery Dis) Vol. 10 Issue 7 Pg. 501-7 (Oct 1999) ISSN: 0954-6928 [Print] England
PMID10562918 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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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