Journal of Electrocardiology
Volume 43, Issue 2 , Pages 113-120 , March 2010

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

  • Michael Ringborn, MD

      Affiliations

    • Department of Cardiology, Lund University, Lund, Sweden
    • Thoracic Center, Blekingesjukhuset, Karlskrona, Sweden
    • Corresponding Author InformationCorresponding author. Thoracic Center, Blekinge Hospital, SE- 371 85 Karlskrona, Sweden.
    • ,
  • Jonas Pettersson, MD, PhD

      Affiliations

    • Department of Clinical Physiology, Lund University, Lund, Sweden
    • ,
  • Eva Persson, MD, PhD

      Affiliations

    • Department of Clinical Physiology, Lund University, Lund, Sweden
    • ,
  • Stafford G. Warren, MD

      Affiliations

    • Charleston Area Medical Center, Charleston, WV, USA
    • ,
  • Pyotr Platonov, MD, PhD

      Affiliations

    • Department of Cardiology, Lund University, Lund, Sweden
    • ,
  • Olle Pahlm, MD, PhD

      Affiliations

    • Department of Clinical Physiology, Lund University, Lund, Sweden
    • ,
  • Galen S. Wagner, MD

      Affiliations

    • Duke University Medical Center, Durham, NC, USA

Received 13 October 2009

References 

  1. Holland RP, Brooks H. TQ-ST segment mapping: critical relead and analysis of current concepts. Am J Cardiol. 1977;40:110
  2. Myocardial infarction redefined—a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Eur Heart J. 2000;21:1502
  3. Menown IBA, MacKenzie G, Adgey AAJ. Optimizing the initial 12-lead electrocardiographic diagnosis of acute myocardial infarction. Eur Heart J. 2000;21:275
  4. Persson E, Pettersson J, Ringborn M, et al. Comparison of ST-segment deviation to scintigraphically quantified myocardial ischemia during acute coronary occlusion induced by percutaneous transluminal coronary angioplasty. Am J Cardiol. 2006;97:295
  5. Steg PG, Faraggi M, Himbert D, et al. Comparison using dynamic vectorcardiography and MIBI SPECT of ST-segment changes and myocardial MIBI uptake during percutaneous transluminal coronary angioplasty of the left anterior descending coronary artery. Am J Cardiol. 1995;75:998
  6. Faraggi M, Steg PG, Francois D, et al. Residual area at risk after anterior myocardial infarction: are ST-segment changes during coronary angioplasty a reliable indicator? A comparison with technetium 99m-labeled sestamibi single-photon emission computed tomography. J Nucl Cardiol. 1997;4:11
  7. Sand NP, Rehling M, Bagger JP, Thuesen L, Flo C, Nielsen TT. Functional significance of recruitable collaterals during temporary coronary occlusion evaluated by 99mTc-sestamibi single-photon emission computerized tomography. J Am Coll Cardiol. 2000;35:624
  8. Jensen SM, Karp K, Rask P, Näslund U. Assessment of myocardium at risk with vectorcardiography and technetium-99m-sestamibi-single photon emission computed tomography during coronary angioplasty. Scand Cardiovasc J. 2002;36:11
  9. Schröder K, Wegscheider K, Zeymer U, Neuhaus KL, Schröder R. Extent of ST-segment deviation in the single ECG lead of maximum deviation present at 90 or 180 minutes after start of thrombolytic therapy best predicts outcome in acute myocardial infarction. Z Kardiol. 2001;90:557
  10. Schröder K, Wegscheider K, Zeymer U, Tebbe U, Schröder R. Extent of ST-segment deviation in a single electrocardiogram lead of maximum 90 min after thrombolysis as a predictor of medium-term mortality in acute myocardial infarction. Lancet. 2001;358:1479
  11. Weston P, Johanson P, Schwartz LM, Maynard C, Jennings RB, Wagner GS. The value of both ST-segment and QRS complex changes during acute coronary occlusion for prediction of reperfusion-induced myocardial salvage in a canine model. J Electrocardiol. 2007;40:19
  12. Wagner NB, Sevilla DC, Krukoff MW, et al. Transient alterations of the QRS complex and the ST segment during percutaneous transluminal angioplasty of the left anterior descending coronary artery. Am J Cardiol. 1988;62:1038
  13. Sclarovsky S. Chapter 2: Acute ischaemic syndrome—the pre-infarction ischaemic syndrome. In:  Sclarovsky S editors. Electrocardiography of acute myocardial ischaemic syndromes. London, UK: Martin Dunitz Ltd; 1999;p. 45
  14. Sclarovsky S, Mager A, Kusniec J, et al. Electrocardiographic classification of acute myocardial ischemia. Isr J Med Sci. 1990;26:525
  15. Birnbaum Y, Herz I, Sclarovsky S, et al. Prognostic significance of the admission electrocardiogram in acute myocardial infarction. J Am Coll Cardiol. 1996;27:1128
  16. Birnbaum Y, Criger DA, Wagner GS, et al. Prediction of the extent and severity of left ventricular dysfunction in anterior acute myocardial infarction by the admission electrocardiogram. Am Heart J. 2001;141:915
  17. Birnbaum Y, Wagner GS. The initial electrocardiographic pattern in acute myocardial infarction: correlation with infarct size. J Electrocardiol. 1999;32(Suppl):122
  18. Birnbaum Y, Goodman SG, Barr A, et al. Comparison of primary coronary angioplasty versus thrombolysis in patients with ST segment elevation acute myocardial infarction and Grade II and Grade III myocardial ischemia on the enrolment electrocardiogram. Am J Cardiol. 2001;88:842
  19. Abboud S, Cohen RJ, Sadeh D. A spectral analysis of the high frequency QRS potentials observed during acute myocardial ischemia in dogs. Int J Cardiol. 1990;26:285
  20. Abboud S, Smith JM, Shargorodsky B, Laniado S, Sadeh D, Cohen RJ. High frequency electrocardiography of three orthogonal leads in dogs during coronary artery occlusion. Pacing Clin Electrophysiol. 1989;12:574
  21. Mor-Avi V, Shargorodsky B, Abboud S, Laniado S, Akselrod S. Effects of coronary occlusion on high-frequency content of the epicardial electrocardiogram and body surface electrocardiogram. Circulation. 1987;76:237
  22. Abboud S, Cohen RJ, Selwyn A, Ganz P, Sadeh D, Friedman PL. Detection of transient myocardial ischemia by computer analysis of standard and signal-averaged high-frequency electrocardiograms in patients undergoing percutaneous transluminal coronary angioplasty. Circulation. 1987;76:585
  23. Pettersson J, Pahlm O, Carro E, et al. Changes in high-frequency QRS components are more sensitive than ST segment deviation for detecting acute coronary occlusion. J Am Coll Cardiol. 2000;36:1827
  24. Pettersson J, Lander P, Pahlm O, Sörnmo L, Warren SG, Wagner GS. Electrocardiographic changes during prolonged coronary artery occlusion in man: comparison of standard and high-frequency recordings. Clin Physiol. 1998;18:179
  25. Aversano T, Rudicoff B, Washington A, Traill S, Coombs V, Raqueno J. High frequency QRS electrocardiography in the detection of reperfusion following thrombolytic therapy. Clin Cardiol. 1994;17:175
  26. Abboud S, Leor J, Eldar M. High frequency ECG during reperfusion therapy of acute myocardial infarction. IEEE Comput Soc, Comput Cardiol. 1990;351
  27. Gibbons RJ, Verani MS, Behrenbeck T, et al. Feasibility of tomographic 99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile imaging for the assessment of myocardial area at risk and the effect of treatment in acute myocardial infarction. Circulation. 1989;80:1277
  28. Haronian HL, Remetz MS, Sinusas AJ, et al. Myocardial risk area defined by Tc-99m-sestamibi imaging during percutaneous transluminal coronary angioplasty: comparison with coronary angiography. J Am Coll Cardiol. 1993;22:1033
  29. Mason RE, Likar I. A new system of multiple-lead exercise electrocardiography. Am Heart J. 1966;71:196
  30. Pahlm O, Sörnmo L. Data processing of exercise ECGs. IEEE Trans Biomed Eng. 1987;34:158
  31. Proakis JG, Manolakis DG. Digital signal processing – principles, algorithms and applications. Upper Saddle River (NJ): Prentice Hall; 1996;
  32. Persson E, Palmer J, Pettersson J, et al. Quantification of myocardial hypoperfusion with 99mTc-sestamibi in patients undergoing prolonged coronary artery balloon occlusion. Nuclear Medicine Com. 2002;23:219
  33. DePuey EG, Berman DS, Garcia EV. In: Cardiac SPECT imaging. New York: Raven Press; 1995;p. 63
  34. Garcia EV, Cooke CD, Van Train KF, et al. Technical aspects of myocardial SPECT imaging with technetium-99m sestamibi. Am J Cardiol. 1990;66:13
  35. Trägårdh E, Pahlm O, Wagner SG, Pettersson J. Reduced high-frequency QRS components in patients with ischemic heart disease compared to normal subjects. J Electrocardiol. 2004;37:157
  36. Watanabe T, Yamaki M, Tachibana H, Kubota I, Tomoike H. Decrease in the high frequency QRS components depending on the local conduction delay. Jpn Circ J. 1998;62:844
  37. Abboud S, Berenfeld O, Sadeh D. Simulation of high-resolution QRS complex using a ventricular model with a fractal conduction system. Effects of ischemia on high-frequency QRS potentials. Circ Res. 1991;68:1751
  38. Trägårdh E, Pettersson J, Wagner SG, Pahlm O. Reduced high-frequency QRS components in electrocardiogram leads facing an area of the heart with intraventricular conduction delay due to bundle branch block. J Electrocardiol. 2007;40:127
  39. Batdorf NJ, Feiverson AH, Schlegel TT. Month-to-month and year-to-year reproducibility of high frequency QRS ECG signals. J Electrocardiol. 2004;37:289
  40. Douglas PK, Batdorf NJ, Evans RT, Feiveson AH, Arenare B, Schlegel TT. Temporal and postural variation of 12-lead high-frequency QRS electrocardiographic signals in asymptomatic individuals. J Electrocardiol. 2006;39:259

☆ 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

Journal of Electrocardiology
Volume 43, Issue 2 , Pages 113-120 , March 2010

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