Body surface potential mapping improves detection of ST segment alteration during percutaneous coronary intervention.

SJ Maynard, JW Riddell, IBA Menown, J Allen, JMCC Anderson, MM Khan, AAJ Adgey

    Research output: Contribution to journalArticle

    Abstract

    Background: The 12-lead electrocardiogram underestimates ST segment alteration in acute coronary syndromes compared with multi-lead body surface mapping. We assessed whether 80-lead mapping would improve detection of ST alteration during percutaneous coronary intervention. Methods: Simultaneous maps and 12-lead electrocardiograms were recorded pre-procedure, during balloon inflation and post-procedure from patients undergoing elective intervention to native coronary arteries. Recordings were obtained from 39 inflations (19 patients). All arteries were successfully stented. Results: Mean 'lead specific' ST alteration (the difference in ST elevation/depression between pre-procedure and inflation recordings in the lead showing maximal ST alteration) was greater on the map than on electrocardiogram, both for ST elevation (0.16+/-0.02 vs. 0.06+/-0.01 mV; p<0.001) and ST depression (0.11+/-0.017 vs. -0.03+/-0.006 mV; p<0.001). During first inflations (n=19), mean lead specific ST elevation and depression on map were greater than on electrocardiogram (0.20+/-0.034 vs. 0.07+/-0.015 mV; p<0.001 and 0.11+/-0.029 vs. 0.03+/-0.009 mV; p=0.001, respectively). Mapping detected greater summated ST elevation and depression during inflation than electrocardiogram (0.04+/-0.005 vs. 0.021+/-0.003 mV; p<0.001 and 0.026+/-0.004 vs. 0.011+/-0.002 mV; p<0.001, respectively). Qualitative analysis of maps and electrocardiograms showed that 21/39 (53.8%) maps recorded during inflation met criteria for myocardial ischaemia compared with 7/39 (17.9%) electrocardiograms (p<0.001). Conclusion: Body surface mapping compared with the 12-lead electrocardiogram improves detection of myocardial ischaemia during intervention. 2003 Elsevier Ireland Ltd. All rights reserved.
    Original languageEnglish
    Pages (from-to)203-210
    JournalInternational Journal of Cardiology
    Volume93
    Issue number2-3
    Publication statusPublished - 2004

    Keywords

    • adult
    • article
    • clinical article
    • controlled study
    • electrocardiogram
    • electrocardiography
    • female
    • heart muscle ischemia/su [Surgery]
    • human
    • male
    • percutaneous coronary intervention
    • priority journal
    • qualitative analysis
    • recording
    • ST segment depression
    • ST segment elevation
    • stent

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