Intracardiac Electrode Detection of Early or Subendocardial Ischemia

Sharon Siegel, Richard Brodman, John Fisher, Jeffrey Matos, Seymour Furman

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

SIEGEL, S., et al.: Intracardiac electrode detection of early or subendocardial ischemia. Subendocardial and early transmural ischemia may have significant clinical consequences while manifesting few ECG changes. Catheters were designed to be introduced transvenously into the right ventricle (RV), and coronary sinus (CS) and transarterially into the left ventricle (LV). The intracavitary electrodes were modified so that the electrodes would not contact the endocardium. In twenty‐two dogs ninety‐eight graded stenoses of the circumflex and left anterior descending coronary arteries were performed while electrograms (EGM) were recorded simultaneously from the intracardiac (IC) electrodes and surface ECG. Of those stenoses resulting in only nonspecific ECG changes, there were specific ischemic changes on 100% of LV, 60% of RV, and 89% of CS electrograms. Of those stenoses which resulted in no ECG change, there were specific ischemic changes in the 9/31 (29%) of LV, 3/31 (10%) of RV, and 6/31 (19%) of CS electrograms. Recognizable patterns of change occur on the intracardiac electrograms in response to both stenosis and reperfusion, earlier than any change on the ECG. Besides being more sensitive, intracardiac electrodes allowed for the detection of ischemia even in the presence of intraventricular conduction defects, strain patterns, and possibly other situations which might otherwise mask ischemic changes on the ECG.

Original languageEnglish (US)
Pages (from-to)892-902
Number of pages11
JournalPacing and Clinical Electrophysiology
Volume5
Issue number6
DOIs
StatePublished - Nov 1982

Keywords

  • ECG changes
  • coronary artery stenosis
  • electrograms
  • intracavitary electrodes
  • subendocardial ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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