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ST-T alternans and myocardial ischemia
1Department of Medicine, State University of New York, Health Science Center at Brooklyn 11203, USA.
Angiology
|March 24, 1999
Summary
Perfusion balloons during angioplasty minimize ischemia and ST-T alternans. This supports the theory that significant myocardial ischemia is required for ST-T alternans to develop during cardiac procedures.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- ST-T alternans during coronary angioplasty suggest significant myocardial ischemia.
- Previous studies linked ST-T alternans to total coronary occlusion and substantial myocardium at risk.
Purpose of the Study:
- To investigate if maintaining coronary perfusion with perfusion balloons reduces ST-T alternans during angioplasty.
- To assess the impact of minimized ischemia on ST-T alternans development.
Main Methods:
- Compared intracoronary electrocardiography findings in patients undergoing standard balloon angioplasty versus perfusion balloon angioplasty.
- Studied 14 patients with standard balloons and 11 patients with perfusion balloons.
Main Results:
- Perfusion angioplasty resulted in significantly less ST segment elevation (0.15 mV vs 1.04 mV, p<0.001).
- ST-T alternans occurred in 43% of patients with standard balloons but in none with perfusion balloons (p<0.001).
- Minimized ischemia correlated with reduced ST segment elevation and absence of ST-T alternans.
Conclusions:
- Perfusion balloon angioplasty significantly reduces ischemia and ST-T alternans.
- Findings support the hypothesis that a large area of ischemic myocardium is necessary for ST-T alternans during coronary interventions.