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Intracoronary ECG May Reveal Dynamic Changes in Tissue-Level Reperfusion During Primary PCI

Emre K Aslanger1, Dursun Akaslan2, Eren Uysaler3

  • 1Department of Cardiology, Health Sciences University, Başakşehir Pine and Sakura City Hospital, Istanbul, Turkey.

JACC. Case Reports
|March 28, 2026
PubMed

Insights

Intracoronary electrocardiogram (IC-ECG) monitoring during percutaneous coronary intervention (PCI) can reveal dynamic ST-segment changes. These changes may indicate microvascular reperfusion issues in patients with myocardial infarction.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Intracoronary electrocardiogram (IC-ECG) monitoring during percutaneous coronary intervention (PCI) shows variable ST-segment behavior post-stent deployment.
  • These ST-segment patterns correlate with distinct myocardial infarct characteristics observed via cardiac magnetic resonance imaging (CMR).

Purpose of the Study:

  • To compare IC-ECG findings during PCI with CMR-defined infarct characteristics.
  • To explore the potential of IC-ECG as a real-time indicator of myocardial reperfusion.

Main Methods:

  • Fifteen patients with anterior myocardial infarction underwent IC-ECG monitoring during primary PCI.
  • Guidewire-based IC-ECG data were collected and correlated with cardiac magnetic resonance imaging results.

Main Results:

  • Dynamic ST-segment changes were observed during sequential steps of primary PCI using IC-ECG.
  • These dynamic changes suggest potential microvascular reperfusion impairment.

Conclusions:

  • IC-ECG recordings during PCI may reflect dynamic ST-segment alterations indicative of microvascular dysfunction.
  • Further research is warranted to establish IC-ECG as a reliable real-time marker for myocardial reperfusion assessment during PCI.
Abstract

Keywords:
cardiac magnetic resonanceelectrocardiogrammyocardial infarction

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