What question did this study set out to answer?

To evaluate short- and long-term electrocardiographic and precordial mapping changes following thrombolytic reperfusion in patients with acute myocardial infarction.

July 1, 1985HeartOpen Access

Myocardial infarction and thrombolysis. Electrocardiographic short term and long term results using precordial mapping.

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Why the study?

Does successful reperfusion following intracoronary streptokinase infusion improve short-term ST segment shifts and long-term precordial R wave amplitude in patients with acute myocardial infarction?

Population

110 patients in two consecutive series: 56 patients with acute myocardial infarction, and a further 54…

Comparison

Intracoronary streptokinase infusion and… vs Patients without reperfusion.

Design

Cohort

Follow-up

4 to 6 months

Authors

RER. von EssenFederal Highway and Transport Research Institute WSWolfgang SchmidtUniversity of Washington RUR. UebisOrthopädische Praxis

Discussion

Member takes

Implication

Reperfusion linked to favorable ECG markers of salvage; supports R-wave mapping research but should not yet change practice.

Key Points

To evaluate short- and long-term electrocardiographic and precordial mapping changes following thrombolytic reperfusion in patients with acute myocardial infarction.
Assessed summated ST segment deviations in limb leads before and immediately after intracoronary streptokinase infusion in 56 consecutive acute myocardial infarction patients, correlating outcomes with coronary angiography.
Tracked 54 patients with anterior myocardial infarction over 4 to 6 months using a standardized 48-electrode precordial mapping system and repeat angiography to quantify R and Q wave dynamics.
In the acute cohort, all 43 patients with angiographically confirmed reperfusion demonstrated a significant reduction in summated ST shift returning virtually to normal, whereas 13 patients without reperfusion showed no significant ST change.
At 4 to 6 months, 36 patients with a patent infarct-related vessel exhibited a significant increase in summated precordial R wave amplitude and fewer leads lacking R waves, whereas 18 patients with unsuccessful thrombolysis or reocclusion had progressive loss of R wave amplitude.

Structured PICO

Does successful reperfusion following intracoronary streptokinase infusion improve short-term ST segment shifts and long-term precordial R wave amplitude in patients with acute myocardial infarction?

Population

110 patients in two consecutive series: 56 patients with acute myocardial infarction, and a further 54 patients with anterior myocardial infarction.

Intervention

Intracoronary streptokinase infusion (thrombolysis) and percutaneous transluminal angioplasty.

Comparator

Patients without reperfusion (unsuccessful thrombolysis or already patent infarct-related artery).

Outcome

Electrocardiographic changes (summated ST segment shift, precordial R waves and Q waves) compared with angiographic findings.surrogate

Precordial R wave mapping is a valuable non-invasive method for assessing myocardial salvage after reperfusion, demonstrating that acute loss of R waves does not necessarily indicate irreversible myocardial damage.

Cite This Study

Essen et al. (1985) studied this question.

synapsesocial.com/papers/6a6f282435aa2c282ce08ee8 https://doi.org/10.1136/hrt.54.1.6

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Myocardial infarction and thrombolysis. Electrocardiographic short term and long term results using precordial mapping.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Myocardial infarction and thrombolysis. Electrocardiographic short term and long term results using precordial mapping.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider