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[Asymptomatic and transitory electrocardiographic changes in the 24 hours following coronary transluminal
J C Quiret1, C Isorni, D Choquet
1Service de cardiologie, hôpital Sud, Amiens.
Insights
Silent arrhythmias and repolarization changes are common after coronary angioplasty. These transient electrical abnormalities, particularly after right coronary artery intervention, do not impact long-term outcomes.
Area of Science:
- Cardiology
- Electrophysiology
- Interventional Cardiology
Context:
- Post-coronary angioplasty monitoring is crucial for assessing procedural success and patient recovery.
- Understanding transient electrical changes after successful intervention is key to interpreting Holter recordings.
Purpose:
- To investigate the incidence and characteristics of arrhythmias and ventricular repolarization changes following successful coronary angioplasty.
- To determine if these silent electrical abnormalities influence mid-term clinical outcomes.
Summary:
- A 24-hour Holter recording was performed on 50 asymptomatic patients immediately after successful coronary angioplasty.
- Arrhythmias (supraventricular and ventricular) and transient repolarization changes (T-wave modification, ST-segment depression) were observed in a significant subset of patients, primarily within 12 hours post-procedure.
- These silent abnormalities, especially after right coronary artery dilatation, were noted but did not affect 6-month follow-up coronary arteriography results.
Impact:
- Identifies common, transient electrical abnormalities post-coronary angioplasty that may otherwise cause concern.
- Suggests that silent Holter findings after successful angioplasty have no adverse impact on mid-term angiographic results.
- Provides valuable data for the interpretation of Holter monitoring in the context of interventional cardiology.
Abstract:
Fifty patients underwent a 24-hour Holter system recording immediately after successful coronary angioplasty. Only those patients who had been "successfully" dilated and who, during the following 2 days, had remained totally symptomless and without changes in standard ECG were selected. Arrhythmias occurred in 18 patients: 12 had supraventricular arrhythmia, including 3 prolonged attacks of tachyarrhythmia due to atrial fibrillation; 6 had ventricular arrhythmia, with numerous extrasystoles in 5 cases and bursts of ventricular tachycardia in 1 case. Changes in ventricular repolarization were recorded as: (1) isolated T-wave modification (11 patients), and (2) ST-segment depression (11 patients) reaching or exceeding 2 mn in 5 cases and lasting from 4 to 33 minutes. These silent and transient electrical abnormalities were observed mostly during the 12 hours which followed transluminal angioplasty, and particularly after dilatation of the right coronary artery. The physiopathological mechanisms of these changes are uncertain, but their occurrence has no influence on mid-term results, i.e. the follow-up coronary arteriography at 6 months.