QRS alterations in body surface potential distributions during percutaneous transluminal coronary angioplasty in single-vessel disease

I. Préda, Réginald Nadeau, Pierre Savard, Denis Hamel, Donald Palisaitis, Mohammad Shenasa, James Nasmith

Research output: Contribution to journalArticle

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Abstract

Body surface QRS potentials were recorded with 63 chest leads in 20 patients with proximal single-vessel disease located on either the left anterior descending coronary artery (n = 10), the right coronary artery (n = 6), or the left circumflex coronary artery (n = 4) before, during, and after percutaneous transluminal coronary angioplasty. In each case, three consecutive inflations of relatively short duration (37 ± 14 seconds) were carried out. Electrical activity was displayed as unipolar electrograms and body surface potential maps. The total QRS complex duration decreased in 14 of the 20 patients. Focal conduction disturbances were observed in six cases; all six had left anterior descending coronary artery occlusion and two were also accompanied by a clear shortening of the right epicardial breakthrough time. In these two cases, an initial activation loss seemed to be characteristic, whereas in the other four cases, a rather diffuse slowing of intraventricular conduction, especially during the terminal portion of the QRS, could be observed. Individual and group mean isointegral difference body surface potential maps (during-minus-before dilation) were considered valuable for the interpretation of localized changes in intraventricular conduction during percutaneous transluminal coronary angioplasty, and their individual variations could, at least partly, be explained by the presence or absence of collateral circulation. Two different hypotheses are suggested to account for the QRS complex shortening observed during short-term myocardial ischemic injury: (1) coronary artery occlusion delayed activation of the portion of the septal region that is normally activated early during the QRS, and/or (2) coronary artery occlusion increased the speed of propagation within the ventricles. Both of these hypotheses are discussed in light of earlier clinical and experimental results.

Original languageEnglish
Pages (from-to)311-322
Number of pages12
JournalJournal of Electrocardiology
Volume27
Issue number4
DOIs
Publication statusPublished - 1994

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Coronary Balloon Angioplasty
Coronary Vessels
Coronary Occlusion
Septum of Brain
Collateral Circulation
Economic Inflation
Dilatation
Thorax
Wounds and Injuries

Keywords

  • body surface potential mapping
  • coronary occlusion
  • ECG changes
  • myocardial ischemia
  • percutaneous transluminal coronary angioplasty

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

QRS alterations in body surface potential distributions during percutaneous transluminal coronary angioplasty in single-vessel disease. / Préda, I.; Nadeau, Réginald; Savard, Pierre; Hamel, Denis; Palisaitis, Donald; Shenasa, Mohammad; Nasmith, James.

In: Journal of Electrocardiology, Vol. 27, No. 4, 1994, p. 311-322.

Research output: Contribution to journalArticle

Préda, I. ; Nadeau, Réginald ; Savard, Pierre ; Hamel, Denis ; Palisaitis, Donald ; Shenasa, Mohammad ; Nasmith, James. / QRS alterations in body surface potential distributions during percutaneous transluminal coronary angioplasty in single-vessel disease. In: Journal of Electrocardiology. 1994 ; Vol. 27, No. 4. pp. 311-322.
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AU - Shenasa, Mohammad

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