Key result
Intracoronary ECG reveals ST-segment alternans missed by surface 12-lead ECG during coronary balloon angioplasty.
Why the study?
ST-segment alternans has been described during coronary angioplasty but its detection on intracoronary versus surface ECG is not well characterized.
Case Report (n=1)
Intracoronary ECG may detect ST-segment alternans during coronary angioplasty that is missed by surface 12-lead ECG.
Intracoronary ECG may detect ischemia missed by surface leads during angioplasty; hypothesis-generating and should not yet change practice.
ST-segment alternans has been described in experimental coronary artery occlusion and in patients with variant angina. It is also seen during coronary angioplasty. This report describes a patient who on balloon inflation during coronary angioplasty demonstrated ST-segment alternans only on intracoronary electrocardiogram but did not on surface 12 lead electrocardiogram. Hemodynamic pulsus alternans of the aortic pressure tracing was not observed during electrical alternans.
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Saito et al. (1998) conducted a case report in Unstable angina (n=1). Coronary balloon angioplasty was evaluated on Observation of ST-segment alternans. During coronary balloon angioplasty, ST-segment alternans was observed on the intracoronary electrocardiogram but not on the surface 12-lead electrocardiogram.
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