Patterns of ECG changes during occlusion of the left circumflex coronary artery

DOI Web Site Web Site 15 References Open Access
  • Okano Mitsumasa
    Cardiovascular Center, The Tazuke Kofukai Medical Reserch Institute, Kitano Hospital
  • Kato Takao
    Cardiovascular Center, The Tazuke Kofukai Medical Reserch Institute, Kitano Hospital
  • Inoko Moriaki
    Cardiovascular Center, The Tazuke Kofukai Medical Reserch Institute, Kitano Hospital

Bibliographic Information

Other Title
  • 左回旋枝閉塞中の心電図変化パターンの解析
  • ヒダリ カイセン シ ヘイソク チュウ ノ シンデンズ ヘンカ パターン ノ カイセキ

Search this article

Description

Background: The diagnosis of acute coronary syndrome caused by a culprit lesion in the left circumflex coronary artery (LCX) is still difficult. Purpose: The purpose of this study was to characterize the electrocardiographic (ECG) changes during the occlusion of the LCX in patients who underwent a scheduled percutaneous coronary intervention (PCI). We tested the hypothesis that the ischemic area estimated from the ECG changes according to Cabrera’s ECG sequences matches the perfusion area assessed with coronary angiography (CAG). Methods: We retrospectively evaluated 20 patients who underwent a scheduled PCI of the LCX because of a nonobstructive stenotic lesion, at our hospital between April 2013 and February 2014. We compared the ECG data taken before PCI and those taken during the occlusion of the LCX, and recorded the ECG changes according to the Cabrera sequence. The perfusion area was determined with CAG. The data of ECG changes and perfusion area were once de-identified and assessed by two senior cardiologists who were blinded to the results. Results: A total of 20 patients were included in these analyses. Fourteen patients (70%) showed changes in the I and aVL leads. Five patients (25%) showed changes in II, III, and aVF leads. Nine patients (45%) showed changes in the aVR lead. The perfusion areas estimated according to ECG changes were matched in 11 of 14 patients with ECG changes, whereas 6 patients did not show ECG changes. The positive predictive value was 0.76 (95% confidence interval: 0.652-0.786), and the negative predictive value was 1.000 (95% confidence interval: 0.687-1.000). Conclusions: Balloon occlusion of the LCX showed a variety of ECG changes. The perfusion area estimated from the ECG changes according to the Cabrera sequence was matched with the perfusion area assessed with CAG.

Journal

References(15)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top