目的分析前壁导联ST段压低识别急性下壁心肌梗死的罪犯血管的价值。方法选择2005年至2009年60例急性下壁心肌梗死经急诊冠脉造影明确诊断单支冠状动脉闭塞(RCA或LCX)的患者,分析罪犯血管开通前心电图。结果 (1)∑STv1-v3↓/∑STII III ...目的分析前壁导联ST段压低识别急性下壁心肌梗死的罪犯血管的价值。方法选择2005年至2009年60例急性下壁心肌梗死经急诊冠脉造影明确诊断单支冠状动脉闭塞(RCA或LCX)的患者,分析罪犯血管开通前心电图。结果 (1)∑STv1-v3↓/∑STII III aVF↑≤1在预测RCA闭塞中敏感性高于STIII↑>STII↑(91.30%)。(2)预测LCX闭塞∑STv1-v3↓/∑STII III aVF↑>1有相对高的特异性、敏感性、阳性预测值、阴性预测值(91.30%、57.14%、66.67%、87.50%)。结论前壁导联ST段压低在识别急性下壁心肌梗死的罪犯血管中存在重要价值。展开更多
Background- Postpacing precordial T- wave inversion(TWI), known as cardiac memory(CM), mimics ischemic precordial TWI, and there are no established ECG criteria that adequately distinguish between the two. On the basi...Background- Postpacing precordial T- wave inversion(TWI), known as cardiac memory(CM), mimics ischemic precordial TWI, and there are no established ECG criteria that adequately distinguish between the two. On the basis of CM properties(postpacing sinus rhythm T vector approaching the direction of the paced QRS vector), we hypothesized that CM induced by right ventricular pacing would manifest a TWI pattern different from that of precordial ischemic TWI, thereby discriminating between the two. Methods and Results- T- wave axis, polarity, and amplitude on a 12- lead ECG during sinus rhythm were compared between CM and ischemic patients. The CM group incorporated 13 patients who were paced in DDD mode with short atrioventricular delay for 1 week after elective pacemaker implantation. The ischemic group consisted of 47 patients with precordial TWI identified among 228 consecutive patients undergoing percutaneous coronary intervention for an acute coronary syndrome. The combination of(1) positive TaVL,(2) positive or isoelectric T1, and(3) maximal precordial TWI >TWIIII was 92% sensitive and 100% specific for CM, discriminating it from ischemic precordial TWI. Conclusions- CM induced by right ventricular pacing results in a distinctive T- vector pattern that allows discrimination from ischemic precordial T- wave inversions regardless of the coronary artery involved.展开更多
文摘目的分析前壁导联ST段压低识别急性下壁心肌梗死的罪犯血管的价值。方法选择2005年至2009年60例急性下壁心肌梗死经急诊冠脉造影明确诊断单支冠状动脉闭塞(RCA或LCX)的患者,分析罪犯血管开通前心电图。结果 (1)∑STv1-v3↓/∑STII III aVF↑≤1在预测RCA闭塞中敏感性高于STIII↑>STII↑(91.30%)。(2)预测LCX闭塞∑STv1-v3↓/∑STII III aVF↑>1有相对高的特异性、敏感性、阳性预测值、阴性预测值(91.30%、57.14%、66.67%、87.50%)。结论前壁导联ST段压低在识别急性下壁心肌梗死的罪犯血管中存在重要价值。
文摘Background- Postpacing precordial T- wave inversion(TWI), known as cardiac memory(CM), mimics ischemic precordial TWI, and there are no established ECG criteria that adequately distinguish between the two. On the basis of CM properties(postpacing sinus rhythm T vector approaching the direction of the paced QRS vector), we hypothesized that CM induced by right ventricular pacing would manifest a TWI pattern different from that of precordial ischemic TWI, thereby discriminating between the two. Methods and Results- T- wave axis, polarity, and amplitude on a 12- lead ECG during sinus rhythm were compared between CM and ischemic patients. The CM group incorporated 13 patients who were paced in DDD mode with short atrioventricular delay for 1 week after elective pacemaker implantation. The ischemic group consisted of 47 patients with precordial TWI identified among 228 consecutive patients undergoing percutaneous coronary intervention for an acute coronary syndrome. The combination of(1) positive TaVL,(2) positive or isoelectric T1, and(3) maximal precordial TWI >TWIIII was 92% sensitive and 100% specific for CM, discriminating it from ischemic precordial TWI. Conclusions- CM induced by right ventricular pacing results in a distinctive T- vector pattern that allows discrimination from ischemic precordial T- wave inversions regardless of the coronary artery involved.
