R wave peak time and no reflow following primary percutaneous coronary intervention: Immediate and short-term outcomes

Yusuf, Jamal; Pandey, Purneshwar Kumar; Mehta, Vimal; Mukhopadhyay, Saibal

doi:10.1016/j.jelectrocard.2023.03.003

Cited by 2 publications

(6 citation statements)

References 26 publications

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“…Furthermore, the number of leads with Q-waves on ECG was significantly higher in the noreflow group compared to the control group in both studies which reported this parameter (21,22). RWPT was longer in the no-reflow group than the control group in all studies that evaluated it (N = 3) (8,13,14). Two studies evaluated the association between longer PWPT and no-reflow phenomenon, and one study found a significant correlation between prolonged PWPT in the no-reflow group compared to the control group but the other one didn't find any significant differences (19,20).…”

Section: Qualitative Synthesismentioning

confidence: 89%

“…The exact mechanism underlying the association between delayed RWPT on baseline ECG and the occurrence of no-reflow during PPCI has yet to be fully elucidated. However, it has been proposed that delayed RWPT may indicate the presence of late electrical activation of the left ventricle caused by impaired myocardial blood flow (8,14).…”

Section: Discussionmentioning

confidence: 99%

“…All three studies that evaluated the frequency of fQRS consistently reported a significantly higher prevalence of fQRS in the no-reflow group compared to the control group (23)(24)(25). The Q-waves on admission were reported in five studies, and in all of them, patients who developed the no-reflow phenomenon had a higher incidence of Q-waves than the control group (8,14,19,26). Furthermore, the number of leads with Q-waves on ECG was significantly higher in the noreflow group compared to the control group in both studies which reported this parameter (21,22).…”

Section: Qualitative Synthesismentioning

confidence: 99%

“…P-wave dispersion was evaluated between the no-reflow and control groups in one study which found an insignificant difference between the two groups in the baseline ECG (20). None of the six studies that reported ∑STE found a significant difference between the two groups (8,14,16,19,20); however, the no-reflow group exhibited significantly lower ST resolution (STR) compared to the control group (N = 3) (13,14,19). In the one study that evaluated transient ST segment re-elevation, no significant difference was found between the no-reflow group and the control group (22).…”

Section: Qualitative Synthesismentioning

confidence: 99%

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Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis

Jafari Afshar,

Gholami,

Samimisedeh

et al. 2024

Front. Cardiovasc. Med.

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BackgroundThe no-reflow phenomenon affects about one out of five patients undergoing Primary Percutaneous Coronary Intervention (PPCI). As the prolonged no-reflow phenomenon is linked with unfavorable outcomes, making early recognition is crucial for effective management and improved clinical outcomes in these patients. Our review study aimed to determine whether electrocardiogram (ECG) findings before PCI could serve as predictors for the occurrence of the no-reflow phenomenon.Methods and materialsWe systematically searched MEDLINE, Scopus, and Embase to identify relevant studies. The random-effect model using inverse variance and Mantel-Haenszel methods were used to pool the standardized mean differences (SMD) and odds ratios (OR), respectively.ResultSixteen eligible articles (1,473 cases and 4,264 controls) were included in this study. Based on our meta-analysis of baseline ECG findings, the no-reflow group compared to the control group significantly had a higher frequency of fragmented QRS complexes (fQRS) (OR (95% CI): 1.35 (0.32–2.38), P-value = 0.01), and Q-waves (OR (95% CI): 1.97 (1.01–2.94), P-value <0.001). Also, a longer QRS duration (QRSD) (SMD (95% CI): 0.72 (0.21, 1.23), p-value <0.001) and R wave peak time (RWPT) (SMD (95% CI): 1.36 (0.8, 1.93), P < 0.001) were seen in the no-reflow group. The two groups had no significant difference regarding P wave peak time (PWPT), and P wave maximum duration (Pmax) on baseline ECG.ConclusionOur findings suggest that prolonged QRSD, delayed RWPT, higher fQRS prevalence, and the presence of a Q wave on baseline ECG may predict the occurrence of the no-reflow phenomenon in patients undergoing PPCI.

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Section: Qualitative Synthesismentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Qualitative Synthesismentioning

confidence: 99%

Section: Qualitative Synthesismentioning

confidence: 99%

See 2 more Smart Citations

Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis

Jafari Afshar,

Gholami,

Samimisedeh

et al. 2024

Front. Cardiovasc. Med.

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“…So far, prolonged RWPT has been associated with left ventricular hypertrophy (LVH), left ventricular overload, myocardial ischemia, HF, and sudden cardiac death (SCD) [8][9][10][11][12] . Recent studies have shown the relationship between the RWPT and no-reflow and coronary artery disease severity in AMI patients 13,14 .…”

Section: Introductionmentioning

confidence: 99%

The predictive value of R wave peak time to detect thrombus burden in st-segment elevation myocardial infarction: a retrospective cohort study in a tertiary medical center

GuÓven-Óetin,

DemirtaÓ,

Balun

et al. 2023

RIC

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Background: Patients with higher thrombus burden have higher procedural complications and more long-term adverse cardiac events. Detecting patients with high thrombus burden (HTB) before coronary intervention could help avoid procedural complications. Objective: The research aimed to analyze the R wave peak time (RWPT) on the electrocardiogram to predict thrombus burden before coronary angiography in patients with acute ST-segment elevation myocardial infarction (STEMI). Materials and Methods: A total of 159 patients with STEMI were included in the study conducted at a tertiary medical center. The thrombolysis in myocardial infarction (TIMI) thrombus scale was applied to assess the thrombus burden. TIMI thrombus grades 0, 1, 2, and 3 were accepted as low; 4 and 5 had HTB. RWPT was measured from the beginning of the QRS complex to the R-peak from the leads pointing to the infarct-related artery. Results: Patients were divided into two groups according to their angiographically defined thrombus burden as low and high. The low thrombus burden group (LTB) comprised fifty-four patients, whereas the HTB group comprised 105 patients. In the LTB group, RWPT was 47.96 ± 9.17 ms, and in the HTB group was 53.58 ± 8.92 ms; it was significantly longer (p < 0.01). Receiver operating characteristic analysis showed that a cut-off value of preprocedural RWPT of > 46.5 ms predicted the occurrence of HTB with a sensitivity and specificity of 87.62% and 51.85%, respectively (AUC 0.682, 95% CI 0.590-0.774, p < 0.001). Conclusion: The present study evaluated the relationship between the RWPT and thrombus burden in STEMI patients. Based on the results, RWPT is an independent predictor of HTB. (REV INVEST

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R wave peak time and no reflow following primary percutaneous coronary intervention: Immediate and short-term outcomes

Cited by 2 publications

References 26 publications

Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis

Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis

The predictive value of R wave peak time to detect thrombus burden in st-segment elevation myocardial infarction: a retrospective cohort study in a tertiary medical center

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