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Potential of an intracardiac electrogram for the rapid detection of coronary artery occlusion.

Publication ,  Journal Article
Fischell, TA; Fischell, DR; Fischell, RE; Baskerville, S; Hendrick, S; Moshier, C; Harwood, JP; Krucoff, MW
Published in: Cardiovasc Revasc Med
2005

BACKGROUND: Early identification of acute MI and prompt intervention can improve clinical outcomes. It would be valuable to identify a method that could allow the earliest possible detection of myocardial injury or ischemia. METHODS AND RESULTS: This article reports one of the first clinical investigations to examine the ability of an intracardiac right ventricular (RV) electrode to identify the early onset of myocardial ischemia/injury in a cohort of patients undergoing balloon occlusion of a coronary artery during percutaneous transluminal coronary angioplasty. The primary data set for analysis included observations from 14 patients with 17 lesions, with a matched comparison of a V6 surface lead and the RV to left upper chest, "intracardiac" lead. The intracardiac lead was sensitive in detecting myocardial injury current/ischemia. There was a 36.4+/-5.6% ST-segment shift, relative to the amplitude of the QRS complex, in the intracardiac lead at 2 min, compared with a 10.1+/-1.9% ST shift from a surface lead (P=.00011). The RV to left upper chest lead detected a >10% shift in ST segment within 2 min in 17 (100%) of 17 cases vs. 8 (47%) of 17 for a V6 surface lead. The intracardiac lead provided detection of ischemia in all three major epicardial coronary distributions. CONCLUSIONS: This study demonstrates the ability of an intracardiac (RV apex to left upper chest) lead to rapidly detect myocardial ischemia/injury during acute coronary occlusion in the setting of balloon angioplasty. The results of this study suggest that a simple implantable system resembling a ventricular pacemaker could be programmed to assist in the very early diagnosis of acute myocardial infarction.

Duke Scholars

Published In

Cardiovasc Revasc Med

DOI

ISSN

1553-8389

Publication Date

2005

Volume

6

Issue

1

Start / End Page

14 / 20

Location

United States

Related Subject Headings

  • Time Factors
  • Signal Processing, Computer-Assisted
  • Sensitivity and Specificity
  • Pilot Projects
  • Pacemaker, Artificial
  • Myocardial Ischemia
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fischell, T. A., Fischell, D. R., Fischell, R. E., Baskerville, S., Hendrick, S., Moshier, C., … Krucoff, M. W. (2005). Potential of an intracardiac electrogram for the rapid detection of coronary artery occlusion. Cardiovasc Revasc Med, 6(1), 14–20. https://doi.org/10.1016/j.carrev.2005.05.002
Fischell, Tim A., David R. Fischell, Robert E. Fischell, Susan Baskerville, Susan Hendrick, Carol Moshier, Jonathan P. Harwood, and Mitchell W. Krucoff. “Potential of an intracardiac electrogram for the rapid detection of coronary artery occlusion.Cardiovasc Revasc Med 6, no. 1 (2005): 14–20. https://doi.org/10.1016/j.carrev.2005.05.002.
Fischell TA, Fischell DR, Fischell RE, Baskerville S, Hendrick S, Moshier C, et al. Potential of an intracardiac electrogram for the rapid detection of coronary artery occlusion. Cardiovasc Revasc Med. 2005;6(1):14–20.
Fischell, Tim A., et al. “Potential of an intracardiac electrogram for the rapid detection of coronary artery occlusion.Cardiovasc Revasc Med, vol. 6, no. 1, 2005, pp. 14–20. Pubmed, doi:10.1016/j.carrev.2005.05.002.
Fischell TA, Fischell DR, Fischell RE, Baskerville S, Hendrick S, Moshier C, Harwood JP, Krucoff MW. Potential of an intracardiac electrogram for the rapid detection of coronary artery occlusion. Cardiovasc Revasc Med. 2005;6(1):14–20.
Journal cover image

Published In

Cardiovasc Revasc Med

DOI

ISSN

1553-8389

Publication Date

2005

Volume

6

Issue

1

Start / End Page

14 / 20

Location

United States

Related Subject Headings

  • Time Factors
  • Signal Processing, Computer-Assisted
  • Sensitivity and Specificity
  • Pilot Projects
  • Pacemaker, Artificial
  • Myocardial Ischemia
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Humans