Changes in electrical vectors correlated with coronary insufficiency with recent symptoms
Cameruddin W Vellani1, Abdul Hakeem2, Satwat Hashmi3
1Department of Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan. camer.vellani@aku.edu.
Insights
Vectorcardiography (VCG) effectively detects myocardial ischemia by analyzing electrical vector changes. This non-invasive technique correlates well with coronary angiography, aiding in identifying significant blood flow obstructions.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- Myocardial ischemia alters cardiac electrical activity.
- Vectorcardiography (VCG) measures spatial cardiac electrical vectors.
- Identifying significant coronary artery obstructions is clinically important.
Purpose of the Study:
- To validate VCG's ability to detect regional myocardial ischemia.
- To identify blood vessels causing significant blood flow obstruction.
- To assess electrophysiological changes post-percutaneous coronary intervention (PCI).
Main Methods:
- VCG records from 37 unstable ischemia patients were analyzed.
- Electrical vector magnitude and direction were measured pre- and post-PCI.
- ECG signals were recorded using bioamplifiers, digitized, and processed by algorithms.
Main Results:
- 36 of 37 patients showed VCG and coronary angiography (CA) congruence.
- 34 patients exhibited electrical vector changes correlating with insufficient blood supply.
- 1 patient showed VCG-detected ischemia with negative CA; 2 showed no changes with non-obstructive arteries.
Conclusions:
- VCG accurately detects myocardial ischemia and correlates with CA findings.
- VCG can identify significant coronary artery obstructions.
- Revascularization via PCI corresponded with expected VCG changes, confirming its utility.
Abstract:
Vectorcardiography (VCG) enables measurement of voltages and directions of resultant spatial vectors in the heart that are altered by myocardial ischemia. To validate the ability of VCG to detect electrophysiological effects of regional myocardial ischemia and identify blood vessels that obstruct blood flow significantly, VCG records of 37 patients who presented with unstable symptoms of ischemia requiring coronary angiography (CA) were processed and analyzed. The difference in magnitude and direction of electrical vectors were measured before and after percutaneous coronary intervention (PCI) to study the significance of changes after revascularization. Bio amplifiers recorded 3 simultaneous orthogonal lead ECG signals with low-pass frequency of 150 Hz without electronic filtration. The analogue signals were digitized and recorded for analysis. The numerical output was processed by algorithms to calculate and display the state of vectors. 36 of 37 patients showed congruence between VCG and CA results: 34 of the 36 showed changes in electrical vectors and insufficient blood supply. 2 showed no changes in electrical vectors and non-obstructive arteries on CA. 1 patient had ischemia detected by VCG, but CA was negative. Blood vessels that were opened with PCI corresponded with regions of myocardial ischemia and expected coronary blood supply on VCG interpretation.
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