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[Ischemic J wave before and post percutaneous coronary intervention in patients with coronary artery disease]
Wu-yi Guo1, Bao Li, Xiao-min Zhang
1Department of Electrocardiogram, Shanxi Cardiovascular Hospital, Taiyuan 030024, China.
Insights
Percutaneous coronary intervention (PCI) improves electrocardiographic ischemic J waves in patients with coronary heart disease (CHD). This study found PCI reduced the amplitude and duration of these waves, indicating a positive impact on cardiac ischemia.
Area of Science:
- Cardiology
- Electrophysiology
- Interventional Cardiology
Context:
- Coronary heart disease (CHD) poses a significant global health burden.
- Electrocardiographic (ECG) findings, such as J waves, can indicate myocardial ischemia.
- Percutaneous coronary intervention (PCI) is a primary revascularization strategy for CHD.
Purpose:
- To investigate the dynamic changes in electrocardiographic ischemic J waves following PCI in patients with CHD.
- To analyze the incidence, amplitude, and temporal characteristics of J waves before and after PCI.
- To compare J wave patterns in different CHD subgroups (unstable angina pectoris vs. acute myocardial infarction) and coronary artery territories.
Summary:
- A study of 162 CHD patients undergoing PCI revealed that J waves were most prevalent in leads II, III, and aVF.
- The incidence, amplitude, and time course of ischemic J waves were significantly reduced post-PCI, particularly in leads II, III, aVF, V3, and V4.
- These findings suggest that PCI positively influences ischemic J wave manifestations in CHD patients.
Impact:
- PCI demonstrates a beneficial effect on reducing electrocardiographic markers of myocardial ischemia.
- The study provides quantitative evidence for the improvement of ischemic J waves after revascularization.
- These results may refine the interpretation of ECG findings in post-PCI CHD patients.
Objective:
To explore the change of electrocardiographic ischemic J wave in patients with coronary heart disease (CHD) underwent percutaneous coronary intervention (PCI).
Methods:
CHD patients (CHD, n = 162) underwent PCI in the hospital were divided into unstable angina pectoris (angina pectoris group, n = 108) and acute myocardial infarction group (AMI group, n = 54), 12-lead electrocardiogram was recorded within 24 hours before and after PCI. Patients were further grouped into left anterior descending artery group and right or circumflex coronary artery stenosis group. The incidence, amplitude and time course of J waves were measured and analyzed.
Results:
(1) The highest incidence of J wave appeared in II, III, aVF leads pre- and post-PCI in CHD groups (33.95%, 22.84%, 26.54% and 30.86%, 19.75%, 23.46%). Higher incidence of J wave in AMI group was evidenced in V(5), II, aVF, III, V(3) leads before PCI (33.33%, 27.78%, 16.67%, 12.96%, 11.11%) and in V(5), II, aVF, aVL, III leads after PCI (22.22%, 22.22%, 14.81%, 12.96%, 9.26%). (2) Before PCI, higher incidence of J wave was found in V(5), V(6) leads (25.78%) in left anterior descending artery group and in II, III, aVF leads (35.37%) in right or circumflex coronary artery stenosis group. After PCI, the higher incidence of J wave in left anterior descending artery group and right or circumflex coronary artery stenosis group was evidenced in II, III, aVF leads (21.09% and 35.37%, respectively). (3) The ischemic J wave' amplitude and time course in II, III, aVF, V(3), V(4) leads were significantly reduced post PCI in CHD patients.
Conclusions:
Higher incidence of J wave was found in II, III, aVF in CHD patients. PCI is associated with reduced amplitude and time course of J wave suggesting PCI could improve ischemic J waves in CHD patients.
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