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Electrocardiographic ST-segment monitoring during controlled occlusion of coronary arteries.

Research paper by Andreas A Haeberlin, Evelyn E Studer, Thomas T Niederhauser, Michael M Stoller, Thanks T Marisa, Josef J Goette, Marcel M Jacomet, Tobias T Traupe, Christian C Seiler, Rolf R Vogel

Indexed on: 19 Nov '13Published on: 19 Nov '13Published in: Journal of Electrocardiology



Abstract

Ischemia monitoring cannot always be performed by 12-lead ECG. Hence, the individual performance of the ECG leads is crucial. No experimental data on the ECG's specificity for transient ischemia exist.In 45 patients a 19-lead ECG was registered during a 1-minute balloon occlusion of a coronary artery (left anterior descending artery [LAD], right coronary artery [RCA] or left circumflex artery [LCX]). ST-segment shifts and sensitivity/specificity of the leads were measured.During LAD occlusion, V3 showed maximal ST-segment elevation (0.26mV [IQR 0.16-0.33mV], p=0.001) and sensitivity/specificity (88% and 80%). During RCA occlusion, III showed maximal ST-elevation (0.2mV [IQR 0.09-0.26mV], p=0.004), aVF had the best sensitivity/specificity (85% and 68%). During LCX occlusion, V6 showed maximal ST-segment elevation (0.04mV [IQR 0.02-0.14mV], p=0.005), and sensitivity/specificity was (31%/92%) but could be improved (63%/72%) using an optimized cut-off for ischemia.V3, aVF and V6 show the best performance to detect transient ischemia.