The effects of thrombolytic therapy on the high-resolution electrocardiogram after myocardial infarction

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Acute myocardial infarction (AMI) remains a leading cause of mortality.
• Thrombolytic therapy is a critical treatment for AMI, aiming to restore blood flow.
• Assessing treatment efficacy non-invasively is crucial for patient management.

Purpose of the Study:

• To evaluate the effects of thrombolytic treatment on electrocardiographic (ECG) parameters in patients post-myocardial infarction.
• To correlate ECG findings with treatment success and timing.
• To investigate specific ECG markers indicative of successful reperfusion.

Main Methods:

• High-resolution ECG, 24-hour Holter monitoring, exercise testing, and radionuclide ventriculography were used.
• Analysis included filtered QRS duration and root mean square (RMS) voltage of the QRS complex.
• Patients were categorized into treated (thrombolysis) and control groups.

Main Results:

• Filtered QRS duration was significantly shorter in reperfused patients (83 ± 10 ms) compared to controls (89 ± 12 ms; P=0.017).
• In inferior infarcts, reperfused patients had shorter filtered QRS duration (83 ± 11 ms vs. 89 ± 10 ms; P=0.044).
• Higher RMS voltage in anteroseptal infarcts and earlier treatment groups indicated successful reperfusion.

Conclusions:

• Thrombolytic therapy significantly impacts ECG parameters, particularly filtered QRS duration, in reperfused myocardial infarction.
• Specific ECG metrics, like RMS voltage, can serve as indicators of successful reperfusion and treatment timing.
• These findings support the use of advanced ECG analysis for assessing thrombolytic therapy effectiveness.