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Reversible late potentials due to ischemia.

D A Rubin1, C Sorbera, J Cook

  • 1Division of Cardiology, Westchester County Medical Center, New York Medical College, Valhalla 10595.

Pacing and Clinical Electrophysiology : PACE
|December 1, 1992
PubMed
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Ischemia during angioplasty can cause reversible late potentials, particularly in patients with prior myocardial infarction. These findings suggest a substrate for ventricular tachycardia may develop during ischemic events.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Ischemic Heart Disease

Background:

  • Reversible late potentials (RLPs) are associated with ventricular arrhythmias.
  • Ischemia is a known trigger for cardiac electrical instability.

Purpose of the Study:

  • To investigate the role of ischemia in the development of reversible late potentials.
  • To identify predictors for RLP development during percutaneous transluminal coronary angioplasty (PTCA).

Main Methods:

  • Signal-averaged electrocardiograms (SAECGs) were recorded in 19 patients before, during, and after PTCA.
  • Ischemia was induced by balloon inflation during PTCA.

Main Results:

  • Five out of 19 patients developed late potentials during ischemia, which resolved post-angioplasty.

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  • No significant correlation was found between RLP development and age, sex, ejection fraction, or hemodynamic parameters.
  • A history of myocardial infarction was associated with a higher likelihood of developing late potentials.

    • Conclusions:

    • Ischemia induced during PTCA can lead to reversible late potentials.
    • Patients with prior myocardial infarction may be more susceptible to developing the electrical substrate for reentrant ventricular tachycardia during ischemic episodes.