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The impact of autoperfusion on quantitative electrocardiographic parameters of ischemia severity, extent, and "burden" during salvage of elective coronary angioplasty.

Publication ,  Journal Article
Krucoff, MW; Veldkamp, RF; Kanani, PM; Crater, S; Sawchak, SR; Wildermann, NM; Bengtson, JR; Pope, JE; Sketch, MH; Phillips, HR
Published in: J Invasive Cardiol
September 1994

Long angioplasty inflations have been reported using an autoperfusion system that delivers oxygenated blood distal to the balloon segment. The safety and efficacy of this system has been demonstrated in anatomically selected patients. The clinical use, however, is frequently to stabilize intimal dissection in unselected patients. We reviewed 12-lead continuous electrocardiographic (ECG) recordings in 40 patients in whom prolonged salvage with autoperfusion was attempted. Sub-optimal results were stabilized in 36 of 40, while 4 patients had urgent bypass. The presence of ischemia, as > or = 100 uV ST elevation over the 12 lead ECG, and the total ST deviation over all leads over the entire inflation period (total ischemic "burden") were compared within each patient between the longest standard balloon and autoperfusion inflations. Median duration of inflation was 3.03 min. with balloon vs. 15.6 min. with autoperfusion (p < 0.00002). Of the 40 patients, 35 (87%) had ECG ischemia with balloon vs. 18 (45%) with autoperfusion (p < .00002). Median severity of peak ST deviation was 321 uV with balloon vs. 132 uV with autoperfusion (p = 0.0001). Median extent of ST elevation was 3 leads with balloon vs. 0 leads with autoperfusion (p = 0.0001). Median total ischemic burden was similar with balloon (1173 uVmin) and autoperfusion (1083 uVmin, NS) despite the fivefold longer inflation duration with autoperfusion. Thus, in patients selected by clinical necessity rather than optimal anatomy, severity and extent of ST elevation were significantly reduced, although not entirely eliminated, by autoperfusion.

Duke Scholars

Published In

J Invasive Cardiol

ISSN

1042-3931

Publication Date

September 1994

Volume

6

Issue

7

Start / End Page

234 / 240

Location

United States

Related Subject Headings

  • Perfusion
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electrocardiography
  • Cardiovascular System & Hematology
  • Angioplasty, Balloon, Coronary
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
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MLA
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Krucoff, M. W., Veldkamp, R. F., Kanani, P. M., Crater, S., Sawchak, S. R., Wildermann, N. M., … Phillips, H. R. (1994). The impact of autoperfusion on quantitative electrocardiographic parameters of ischemia severity, extent, and "burden" during salvage of elective coronary angioplasty. J Invasive Cardiol, 6(7), 234–240.
Krucoff, M. W., R. F. Veldkamp, P. M. Kanani, S. Crater, S. R. Sawchak, N. M. Wildermann, J. R. Bengtson, J. E. Pope, M. H. Sketch, and H. R. Phillips. “The impact of autoperfusion on quantitative electrocardiographic parameters of ischemia severity, extent, and "burden" during salvage of elective coronary angioplasty.J Invasive Cardiol 6, no. 7 (September 1994): 234–40.
Krucoff MW, Veldkamp RF, Kanani PM, Crater S, Sawchak SR, Wildermann NM, et al. The impact of autoperfusion on quantitative electrocardiographic parameters of ischemia severity, extent, and "burden" during salvage of elective coronary angioplasty. J Invasive Cardiol. 1994 Sep;6(7):234–40.
Krucoff MW, Veldkamp RF, Kanani PM, Crater S, Sawchak SR, Wildermann NM, Bengtson JR, Pope JE, Sketch MH, Phillips HR. The impact of autoperfusion on quantitative electrocardiographic parameters of ischemia severity, extent, and "burden" during salvage of elective coronary angioplasty. J Invasive Cardiol. 1994 Sep;6(7):234–240.

Published In

J Invasive Cardiol

ISSN

1042-3931

Publication Date

September 1994

Volume

6

Issue

7

Start / End Page

234 / 240

Location

United States

Related Subject Headings

  • Perfusion
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electrocardiography
  • Cardiovascular System & Hematology
  • Angioplasty, Balloon, Coronary
  • 3201 Cardiovascular medicine and haematology