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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

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Published on: December 28, 2012

ST segment elevation in one lead: a case report.

Luay Rifai¹, Muhyaldeen Dia

¹Department of Internal Medicine, University of Illinois in Chicago/Advocate Christ Medical Center, Oak Lawn, USA.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc

|April 28, 2012

Summary

An unusual electrocardiogram finding showed ST-segment elevation due to a temporary pacemaker lead, mimicking injury patterns. This case highlights how device contact can create current-of-injury signals on surface ECGs.

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Area of Science:

Cardiology
Electrophysiology

Background:

Electrocardiogram (ECG) abnormalities can arise from various cardiac conditions.
ST-segment elevation typically indicates myocardial ischemia or infarction, pericarditis, or bundle branch block.

Observation:

A case report details a 60-year-old woman experiencing ST-segment elevation in lead V(6) post-coronary artery bypass graft surgery.
This elevation was linked to direct contact between the V(6) electrode and a temporary pacemaker's ventricular lead wire.

Findings:

The observed ST-segment elevation mimicked epicardial electrocardiogram findings.
This phenomenon represents a localized current-of-injury pattern caused by the pacing lead's contact with the epicardium.

Implications:

Surface ECG can reflect epicardial current-of-injury patterns, not solely related to ischemia.
Understanding these artifactual changes is crucial for accurate ECG interpretation in patients with pacemakers.