ST Segment Alternans During Percutaneous Transluminal Coronary Angioplasty—A Case Report

Okamoto, Shinya; Inden, M; Konishi, Tokuji; Nakano, Takeshi

doi:10.1177/000331979104200105

Cited by 7 publications

(1 citation statement)

References 12 publications

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“…Electrical alternans of isolated ST-segment alternans during percutaneous transluminal coronary angioplasty (PTCA) has been described previously. 1 However, no report describes both ST segment and QRS alternans with mechanical alternans during PTCA. We report the unusual cardiac alternans that occurred during PTCA in a patient with acute myocardial infarction.…”

Section: Introductionmentioning

confidence: 99%

Electrical and Mechanical Alternans During Percutaneous Transluminal Coronary Angioplasty in a Patient with Acute Myocardial Infarction

et al. 2004

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Section: Introductionmentioning

confidence: 99%

Electrical and Mechanical Alternans During Percutaneous Transluminal Coronary Angioplasty in a Patient with Acute Myocardial Infarction

et al. 2004

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Intracoronary ST‐T alternans during coronary balloon angioplasty

Kwan

Feit

Chadow

et al. 1995

Cathet. Cardiovasc. Diagn.

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To evaluate the presence and clinical significance of electrical alternans during PTCA, intracoronary electrocardiography (ic-ECG) was performed in 65 consecutive lesions. ST-T alternans, defined as a beat-to-beat difference in the ST elevation > or = 1 mm, was present in five lesions (7.7%), all in the proximal left anterior descending (LAD) coronary artery. The phenomenon was seen only after 130 sec (mean 174 +/- 57) of balloon inflation. Only two of the five showed ST-T alternans simultaneously on both surface and ic-ECG. One of five patients had premature ventricular contractions following ST-T alternans. Three of these five lesions required a second balloon inflation with duration of > or = 300 sec; there was no ST-T alternans on the second inflation in any of these lesions. We conclude: (1) the detection of ST-T alternans during PTCA is enhanced by use of ic-ECG, (2) electrical alternans during PTCA was seen only in proximal LAD lesions, implicating a large amount of ischemic myocardium as a requisite for the phenomenon, (3) electrical alternans is not immediate, requiring a certain duration of balloon occlusion and hence ischemia to occur, and (4) the absence of ST-T alternans during second balloon inflations suggests ischemic preconditioning may abolish this phenomenon.

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Characterization of Repolarization Alternans During Ischemia: Time-Course and Spatial Analysis

Martínez¹,

Olmos²,

Wagner³

et al. 2006

IEEE Trans. Biomed. Eng.

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T-wave alternans (TWA) has been linked to increased vulnerability to ventricular fibrillation in different settings including myocardial ischemia. In this study, we propose a methodology for the characterization of TWA induced by transient, regional ischemia. We studied the prevalence, magnitude and spatio-temporal relationship between TWA and ischemia in 95 patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Two electrocardiogram records of each patient, a control recording before PTCA and the PTCA record, were analyzed using a robust, recently proposed method for TWA analysis. The detected episodes were characterized in terms of their time-course, lead distribution and alternans waveform. One third of the patients (33.7%) showed TWA episodes during PTCA. The highest prevalence (51.7%) and amplitude were found in patients with left anterior descendent artery occlusion. The onset of TWA was detected after the first 1-2 min of occlusion, suggesting that some level of ischemia must be attained before TWA arises, while disappearance of TWA following reperfusion was much more rapid. The TWA lead distributions and waveforms showed distinct distributions according to the occluded artery reflecting the regional nature of the TWA phenomenon.

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ST Segment Alternans During Percutaneous Transluminal Coronary Angioplasty—A Case Report

Cited by 7 publications

References 12 publications

Electrical and Mechanical Alternans During Percutaneous Transluminal Coronary Angioplasty in a Patient with Acute Myocardial Infarction

Electrical and Mechanical Alternans During Percutaneous Transluminal Coronary Angioplasty in a Patient with Acute Myocardial Infarction

Intracoronary ST‐T alternans during coronary balloon angioplasty

Characterization of Repolarization Alternans During Ischemia: Time-Course and Spatial Analysis

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