Identification of high-risk patients with silent myocardial ischemia after percutaneous transluminal coronary angioplasty by multilead monitoring.
Quantification of total ischemic burden can be improved by use of microprocessor-driven, multichannel, digital, ST-monitoring devices. ST deviation recorded during angioplasty provides a patient-specific template for identification of patients at increased risk for coronary events after angiographically successful dilation. In patients with ST-segment elevation, evidence of these ST "fingerprint" patterns are associated with elevated risk for coronary events in the postangioplasty period. Such risk is not seen in patients with ST-segment depression or with no ST changes. The increased monitoring capability afforded with digitized 3- or 12-lead monitoring creates new criteria for what constitutes accurate determination of total ischemic burden.
Krucoff
M
M
Division of Cardiology, Georgetown University Hospital, Washington, D.C. 20007.
D000800:Angioplasty, Balloon; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008991:Monitoring, Physiologic; D011379:Prognosis; D012306:Risk