Electrocardiography and postextrasystolic potentiation: utilization of the two methods to predict
M W Cooper1, R Mitchell, L O Lutherer
1Texas Tech University Health Science Center, Lubbock.
Clinical Cardiology
|March 1, 1991
Summary
Postextrasystolic potentiation (PESP) effectively predicts systolic wall function improvement after revascularization, even with ECG abnormalities. However, multiple Q waves indicate a lower likelihood of recovery.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Myocardial Function
Background:
- Postextrasystolic potentiation (PESP) has been identified as a predictor of systolic wall function (SWF) changes after coronary revascularization.
- The relationship between electrocardiogram (ECG) findings and SWF response requires further elucidation.
Purpose of the Study:
- To analyze ECG changes in myocardial segments and their correlation with PESP and SWF following coronary revascularization.
- To determine the predictive value of PESP and ECG in assessing post-revascularization SWF improvement.
Main Methods:
- Correlation analysis of ECG parameters (Q waves, ST-segment, T-wave changes) with PESP response and SWF in myocardial segments.
- Evaluation of PESP's predictive capability in the presence of various ECG abnormalities.
Main Results:
- PESP predicted improved SWF in jeopardized segments, irrespective of Q waves, ST, or T-wave changes.
- The presence of Q waves in two or more leads diminished the likelihood of a positive PESP response and predicted minimal SWF improvement.
- A spectrum of PESP responsiveness correlated with ECG changes, suggesting a dissociation between electrical and mechanical cardiac events.
Conclusions:
- ECG and PESP together offer valuable predictive insights into revascularization efficacy, with PESP being a more potent indicator.
- ECG, particularly the presence of multiple Q waves, can predict a low probability of SWF improvement post-revascularization.
- Further research is needed to understand the dissociation between electrical and mechanical cardiac events observed in this study.
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