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Evaluation of myocardial ischemia by signal-averaged electrocardiography using holter monitoring
Selected Abstracts From the 21st Annual Meeting of the International Society of Electrocardiology
Evaluation of Myocardial Ischemia by Signal-averaged Electrocardiography Using Holter Monitoring
syndrome (47 manifest and 5 concealed) to investigate whether the QRST values of the ECG reveal abnormalities in repolarization properties and which, if any, lead of the ECG reflects the abnormalities. The QRST values before, immediately, and l day after ablation were c o m p a r e d to elucidate repolarization changes before and after ablation in 14 left-sided, 5 right-sided, a n d 5 concealed W P W syndrome patients w h o u n d e r w e n t successful ablation. M e a n _+ 2 SD of QRST values from 607 n o r m a l subjects were regarded as normal range at each lead point. The QRST values were abnormally high in lead Vl in 7 of 28 type A W P W syndrome patients and abnormally low in lead III and high in lead aVL in I 0 of 19 type B WPW s y n d r o m e patients. QRS durations in patients with a b n o r m a l QRST values were significantly (P < .05) greater than those with normal values. The abnormalities in QRST values present before ablation remained 1 day after ablation in spite of remarkable changes in ECG configuration. The QRST values did not change significantly in any lead before, immediately after, and 1 day after ablation. These findings demonstrated that the QRST values of the 12-lead ECG m a y provide useful quantitative information on repolarization and cardiac m e m o r y before and after ablation in patients with W P W syndrome.
Cont 40RMS 100RMS 150RMS ICM ICSD
264.6 51.3 23.5 95.7 68.1
*P<.05. t P < .01 (n = 8).
± 45.2 ± 17.5 +- 6.3 ± 0.2 ± 4.1
S. Yakubo, Y. Ozawa, X. Yang, K. Komaki, K. Hanakawa, Nihon University, Tokyo, J a p a n The purpose of this study was to evaluate myocardial ischemia and recovery of ischemia with signalaveraged electrocardiography using Holter monitoring (Holter SAE). The left coronary artery (LCA) was occluded and reperfused by balloon catheterization for 2 hours in eight mongrel dogs. Holter monitoring and Holter SAE were recorded by a machine (model nos. 459 and 563, Del Mar Avionics, Irvine, CA) with three orthogonal leads. Holter SAE was investigated before LCA occlusion (Cont), 2 hours after LCA occlusion (Cor Occ), during LCA reperfusion(Cor Rep), and 30 minutes after LCA reperfusion (Cor Rep 30) (see table below). The index of SAE was the rootm e a n - s q u a r e voltage of the total QRS in 4 0 - 2 5 0 Hz (40RMS), in 1 0 0 - 2 5 0 Hz (100RMS), and in 1 5 0 - 2 5 0 Hz (150RMS). Spectral turbulence of the Holter SAE was calculated. Indices of the Holter SAE were interslice correlation m e a n (ICM) and interslice correlation standard deviation (ICSD). The Holter SAE correctly evaluated myocardial ischemia caused by LCA occlusion and recovery of ischemia by reperfusion of the LCA.
Cor Occ 218.7 35.6 li.8 91.6 109.9
± ± ± ± ±
87
43.9t 14.3" 5.6* 0.6* 26.5*
Cor Rep 249.8 47.6 14.7 91.8 98.8
± 51.4" ± 14.5" -+ 3.3 ± 0.4 ± 13.5
Cor Rep 30 268.5 49.7 15.3 93.4 79.2
± ± ± ± ±
63.4 7.3 4.5 0.7 10.5
Evaluation of Myocardial Ischemia by Signal-averaged Electrocardiography Using Holter Monitoring
syndrome (47 manifest and 5 concealed) to investigate whether the QRST values of the ECG reveal abnormalities in repolarization properties and which, if any, lead of the ECG reflects the abnormalities. The QRST values before, immediately, and l day after ablation were c o m p a r e d to elucidate repolarization changes before and after ablation in 14 left-sided, 5 right-sided, a n d 5 concealed W P W syndrome patients w h o u n d e r w e n t successful ablation. M e a n _+ 2 SD of QRST values from 607 n o r m a l subjects were regarded as normal range at each lead point. The QRST values were abnormally high in lead Vl in 7 of 28 type A W P W syndrome patients and abnormally low in lead III and high in lead aVL in I 0 of 19 type B WPW s y n d r o m e patients. QRS durations in patients with a b n o r m a l QRST values were significantly (P < .05) greater than those with normal values. The abnormalities in QRST values present before ablation remained 1 day after ablation in spite of remarkable changes in ECG configuration. The QRST values did not change significantly in any lead before, immediately after, and 1 day after ablation. These findings demonstrated that the QRST values of the 12-lead ECG m a y provide useful quantitative information on repolarization and cardiac m e m o r y before and after ablation in patients with W P W syndrome.
Cont 40RMS 100RMS 150RMS ICM ICSD
264.6 51.3 23.5 95.7 68.1
*P<.05. t P < .01 (n = 8).
± 45.2 ± 17.5 +- 6.3 ± 0.2 ± 4.1
S. Yakubo, Y. Ozawa, X. Yang, K. Komaki, K. Hanakawa, Nihon University, Tokyo, J a p a n The purpose of this study was to evaluate myocardial ischemia and recovery of ischemia with signalaveraged electrocardiography using Holter monitoring (Holter SAE). The left coronary artery (LCA) was occluded and reperfused by balloon catheterization for 2 hours in eight mongrel dogs. Holter monitoring and Holter SAE were recorded by a machine (model nos. 459 and 563, Del Mar Avionics, Irvine, CA) with three orthogonal leads. Holter SAE was investigated before LCA occlusion (Cont), 2 hours after LCA occlusion (Cor Occ), during LCA reperfusion(Cor Rep), and 30 minutes after LCA reperfusion (Cor Rep 30) (see table below). The index of SAE was the rootm e a n - s q u a r e voltage of the total QRS in 4 0 - 2 5 0 Hz (40RMS), in 1 0 0 - 2 5 0 Hz (100RMS), and in 1 5 0 - 2 5 0 Hz (150RMS). Spectral turbulence of the Holter SAE was calculated. Indices of the Holter SAE were interslice correlation m e a n (ICM) and interslice correlation standard deviation (ICSD). The Holter SAE correctly evaluated myocardial ischemia caused by LCA occlusion and recovery of ischemia by reperfusion of the LCA.
Cor Occ 218.7 35.6 li.8 91.6 109.9
± ± ± ± ±
87
43.9t 14.3" 5.6* 0.6* 26.5*
Cor Rep 249.8 47.6 14.7 91.8 98.8
± 51.4" ± 14.5" -+ 3.3 ± 0.4 ± 13.5
Cor Rep 30 268.5 49.7 15.3 93.4 79.2
± ± ± ± ±
63.4 7.3 4.5 0.7 10.5