[ECG in acute myocardial infarct. Continuous registration in thrombolytic therapy].
For 35 patients with acute myocardial infarction undergoing thrombolytic therapy (31 patients with streptokinase and 4 with rt-PA), the treatment effect was assessed angiographically and correlated with ECG changes. These ECG changes were found by continuous registration of eight "strategically" located precordial leads in patients with anterior myocardial infarction, and five precordial leads plus three limb leads in those with posterior myocardial infarction. In 31 patients (group A), successful reperfusion could be verified by angiography, while in 4 patients the infarct-related vessel remained closed. In 3 further cases (group B), recanalization could be achieved only by additional mechanical intervention. The average duration of ECG surveillance was 87 min in group A and 85 min in group B. A significant change of R-amplitudes during this period of time could not be observed. ST-60-value of group A (total of ST-elevations and depressions 60 msec after S of all surveillance electrodes, divided by number of electrodes) was reduced under thrombolysis from 0.377 mV (SD +/- 0.270) to 0.133 mV (SD +/- 0.118) (p less than 0.004). This means a reduction of 64%, while the corresponding values in group B did not change (0.535 mV, respectively 0.546 mV) before and after therapy. When only the electrode with the highest ST-60-value was checked before therapy ("sensitive lead"), reduction in group A was as high as 71%. Except for two patients, all other 29 patients with successful reperfusion either precordially or in the limb leads showed a reduction of ST-segment abnormalities (ST 60) of more than 50% during surveillance time. This could not be observed in any of the unsuccessfully treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)
von Essen
R
R
Medizinische Klinik, RWTH Aachen.
Effert
S
S
Silny
J
J
Rau
G
G
Kruse
E
E
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects*; D015716:Electrocardiography, Ambulatory / Q000187:drug effects*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011994:Recombinant Proteins / Q000008:administration & dosage; D016037:Single-Blind Method; D013300:Streptokinase / Q000008:administration & dosage*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
D011994:Recombinant Proteins; D013300:Streptokinase; D010959:Tissue Plasminogen Activator
Das EKG beim akuten Myokardinfarkt. Kontinuierliche Registrierung während der thrombolytischen Therapie.