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Volume 43, Issue 2, Pages 113-120 (March 2010)


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Comparison of high-frequency QRS components and ST-segment elevation to detect and quantify acute myocardial ischemia☆☆

Michael Ringborn, MDabCorresponding Author Informationemail address, Jonas Pettersson, MD, PhDc, Eva Persson, MD, PhDc, Stafford G. Warren, MDd, Pyotr Platonov, MD, PhDa, Olle Pahlm, MD, PhDc, Galen S. Wagner, MDe

Received 13 October 2009 published online 11 January 2010.

Abstract 

Objective

This study tests the ability of high-frequency components of the depolarization phase (HF-QRS) vs conventional ST-elevation criteria to detect and quantify myocardial ischemia.

Methods

Twenty-one patients admitted for elective percutaneous coronary intervention were included. Quantification of the ischemia was made by myocardial scintigraphy. High-resolution electrocardiogram before and during percutaneous coronary intervention was recorded and signal averaged. The HF-QRS were determined within the frequency band 150 to 250 Hz. ST-segment deviation was measured in the standard frequency range (<100 Hz).

Results

HF-QRS criteria were met by 76% of the patients, whereas 38% met the ST-elevation criteria (P = .008). Both HF-QRS reduction and ST elevation correlated significantly with the amount of ischemia (HF-QRS: r = 0.59, P = .005 for extent and r = 0.69, P = .001 for severity; ST elevation: r = 0.49, P = .023 for extent and r = 0.57, P = .007 for severity).

Conclusions

This study suggests that HF-QRS analysis could provide valuable information both to detect acute ischemia and to quantify myocardial area at risk.

a Department of Cardiology, Lund University, Lund, Sweden

b Thoracic Center, Blekingesjukhuset, Karlskrona, Sweden

c Department of Clinical Physiology, Lund University, Lund, Sweden

d Charleston Area Medical Center, Charleston, WV, USA

e Duke University Medical Center, Durham, NC, USA

Corresponding Author InformationCorresponding author. Thoracic Center, Blekinge Hospital, SE- 371 85 Karlskrona, Sweden.

 This study was supported by the American Heart Association, Durham, North Carolina, USA (account 5-21628), The South-Eastern Region of Healthcare, and the Blekinge Scientific Council, Sweden.

☆☆ This study is a part of the STAFF Studies Investigations.

PII: S0022-0736(09)00604-9

doi:10.1016/j.jelectrocard.2009.11.009


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