Key result
Selective coronary arteriography triggers distinct QRS axis shifts, moving leftward during LCA and rightward during RCA injections.
Why the study?
Selective coronary arteriography produces characteristic ST-T changes and significant QRS axis shifts whose genesis needed clarification.
Does selective coronary arteriography produce significant QRS axis shifts in patients undergoing the procedure?
Observational
Does selective coronary arteriography produce significant QRS axis shifts in patients undergoing the procedure?
p-value: p=<0.001
Selective coronary arteriography induces transient but significant QRS axis shifts, likely due to transient ischemic or toxic effects of the contrast dye on the conduction system.
Transient QRS shifts during arteriography signal temporary conduction effects; extends ST-T observations to include contrast-induced axis deviations.
Selective coronary arteriography produces characteristic ST-T changes associated with significant axis shifts. In patients with normal control ÂQRS (mean, +88.6°; sd ± 12.2°) left coronary injections induced an important leftward deviation of the ÂQRS: mean, +8.2°; sd , ±49.1° ( P < 0.001). Right coronary artery opacification changed the ÂQRS from a control mean of +66.5°; sd , ±17.2° to a mean of 89.3°; sd , ±16.7° ( P < 0.001). Left axis shifts after left coronary artery injections were significantly more marked than right axis deviation after right coronary injections. Important increases (beyond 0.02 sec) in ventricular activation time were not observed. These electrocardiographic abnormalities were attributed to the transient ischemic or toxic effect produced by the bolus of dye. This could result in different degrees of complete or incomplete block in the divisions of the left branch or in an extensive peripheral block affecting large areas of the subendocardial regions of the heart.
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Maytin et al. (1970) conducted an observational in Patients undergoing selective coronary arteriography. Selective coronary arteriography vs. Baseline (control ÂQRS) was evaluated on Changes in QRS axis (ÂQRS) (p=<0.001). Selective coronary arteriography induced significant leftward deviation of the QRS axis during left coronary injections and rightward shifts during right coronary opacification (P<0.001).
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