Coronary hemodynamic data in ischemic heart disease according to ischemic behavior during pacing

Cribier, Alain; Berland, Jacques; Cazor, J. L.; Letac, B

doi:10.1002/clc.4960060103

Cited by 5 publications

(1 citation statement)

References 19 publications

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“…Analysis of lactate balance is an accurate method of detecting ischemia [28] and would have been useful for the control of the specificity of the cVCG especially dur ing pacing. However, none of the patients in the ablation group had a history of chest pain and all had normal rest ECGs.…”

Section: Limitationsmentioning

confidence: 99%

On-Line Computerized Vectorcardiography: Influence of Body Position, Heart Rate, Radiographic Contrast Fluid and Myocardial Ischemia

Jensen¹,

Häggmark²,

Johansson

et al. 1997

Cardiology

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On-line computerized vectorcardiography (cVCG) is increasingly being used for continuous monitoring of myocardial ischemia, however, little is known about factors other than ischemia causing electrocardiographic abnormalities. This paper describes how three important cVCG parameters, STC-VM, ST-VM and QRS-VD, are affected by different body positions, myocardial ischemia, contrast injection and increasing heart rate in patients with and without coronary artery disease. The main findings of the study are: contrast injection and different body positions caused major changes in QRS-VD but affected ST-VM and STC-VM to a minor degree. Increasing heart rate by atrial pacing produced substantial changes in all three parameters. Ischemia during angioplasty also produced changes in all three parameters, STC-VM being the most sensitive parameter. In conclusion: (1) STC-VM ( > 50 µV) is the most valuable parameter for monitoring ischemia; (2) we propose ST-VM > 50 µV as criterion instead of previously used 25 µV; (3) QRS-VD cannot be used as a single marker of ischemia, and (4) electrocardiographic changes induced by increased heart rate should be taken into account during interpretation.

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Section: Limitationsmentioning

confidence: 99%

On-Line Computerized Vectorcardiography: Influence of Body Position, Heart Rate, Radiographic Contrast Fluid and Myocardial Ischemia

Jensen¹,

Häggmark²,

Johansson

et al. 1997

Cardiology

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Angina pectoris with angiographically normal coronary arteries: A clinical, hemodynamic, and metabolic study

Berland

Cribier

Cazor

et al. 1984

Clinical Cardiology

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Summary:Seventy-six patients with anginalike chest pain (ALCP) and angiographically normal coronary arteries (NCA) had a study of the myocardial metabolism at rest and during maximal atrial pacing. The results were compared with pain characteristics, electrocardiogram, left ventricular, and coronary hemodynamic data. Coronary blood flow (CBF) was measured by continuous thermodilution. At maximal paced heart rate, the study of the myocardial metabolism distinguished two groups: (1) a first group of 50 patients whose lactate extraction coefficient was equal to or exceeded 9% and was considered as normal (Gr. I, K19%); (2) a second group of 26 patients whose lactate extraction coefficient was below 9% (Gr. 11, K<9%), significant of myocardial ischemia. In group I (K 2 9 % ) , chest pain was usually atypical (typical in only 25 % of cases) and rapid atrial pacing most often caused neither pain nor ECG changes. The hemodynamic and angiographic study showed minor alterations of the left ventricular cavity in 50% of cases. In group I1 (K<9%), chest pain was typical in 50% of the patients and maximal atrial pacing most often caused chest pain (85%) and ST-segment depression (80%). In almost every case, the left ventricular and the coronary angiogms were normal. Only in this group, which had clinical, electrical, and metabolic signs of myocardial ischemia, could the diagnosis of angina pectoris with angiographicall y normal coronary arteries be upheld. However, resting CBF, % increase in CBF for an identical myocardial oxygen demand, and coronary resistances remained comparable in the two groups and no different from a group of 10 control subjects. This study confirms that myocardial ischemia occurs during rapid atrial pacing in 30% of patients with ALCP and NCA, with no obvious explanation, since coronary hemodynamics remain normal. In the remaining 70% of patients where no myocardial ischemia can be demonstrated minor forms of cardiomyopathy or mitral valve prolapse can often be shown.

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Measurement of myocardial oxygen consumption

Cohan

Gewertz

1985

Journal of Surgical Research

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Coronary hemodynamic data in ischemic heart disease according to ischemic behavior during pacing

Cited by 5 publications

References 19 publications

On-Line Computerized Vectorcardiography: Influence of Body Position, Heart Rate, Radiographic Contrast Fluid and Myocardial Ischemia

On-Line Computerized Vectorcardiography: Influence of Body Position, Heart Rate, Radiographic Contrast Fluid and Myocardial Ischemia

Angina pectoris with angiographically normal coronary arteries: A clinical, hemodynamic, and metabolic study

Measurement of myocardial oxygen consumption

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