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Changes in high-frequency QRS components are more sensitive than ST segment deviation for detecting acute coronary artery occlusion

Author

  • Jonas Pettersson
  • E. Carro
  • Lars Edenbrandt
  • Michael Ringborn
  • Leif Sörnmo
  • Stafford G. Warren
  • Galen S. Wagner

Summary, in English

OBJECTIVES



This study describes changes in high-frequency QRS components (HF-QRS) during percutaneous transluminal coronary angioplasty (PTCA) and compares the ability of these changes in HF-QRS and ST-segment deviation in the standard 12-lead electrocardiogram (ECG) to detect acute coronary artery occlusion.



BACKGROUND



Previous studies have shown decreased HF-QRS in the frequency range of 150–250 Hz during acute myocardial ischemia. It would be important to know whether the high-frequency analysis could add information to that available from the ST segments in the standard ECG.



METHODS



The study population consisted of 52 patients undergoing prolonged balloon occlusion during PTCA. Signal-averaged electrocardiograms (SAECG) were recorded prior to and during the balloon inflation. The HF-QRS were determined within a bandwidth of 150–250 Hz in the preinflation and inflation SAECGs. The ST-segment deviation during inflation was determined in the standard frequency range.



RESULTS



The sensitivity for detecting acute coronary artery occlusion was 88% using the high-frequency method. In 71% of the patients there was ST elevation during inflation. If both ST elevation and depression were considered, the sensitivity was 79%. The sensitivity was significantly higher using the high-frequency method, p < 0.002, compared with the assessment of ST elevation.



CONCLUSIONS



Acute coronary artery occlusion is detected with higher sensitivity using high-frequency QRS analysis compared with conventional assessment of ST segments. This result suggests that analysis of HF-QRS could provide an adjunctive tool with high sensitivity for detecting acute myocardial ischemia.

Publishing year

2000

Language

English

Pages

1827-1834

Publication/Series

Journal of the American College of Cardiology

Volume

36

Issue

6

Document type

Journal article

Publisher

Elsevier

Topic

  • Cardiac and Cardiovascular Systems

Status

Published

Research group

  • Nuclear medicine, Malmö

ISBN/ISSN/Other

  • ISSN: 0735-1097