Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction.
Continuous 12-lead electrocardiographic monitoring was performed in 61 patients receiving thrombolytic therapy for an acute myocardial infarction. Coronary angiography within 90 minutes revealed a patent vessel (Thrombolysis in Myocardial Infarction [TIMI] trial 2 or 3) in 44 patients. Early signs of reperfusion were ST-segment normalization (likelihood ratio 16.0), development of terminal T-wave inversion (likelihood ratio 10.6), accelerated idioventricular rhythm (likelihood ratio 6.0), and a twofold increase in ventricular premature complexes (likelihood ratio 2.5). Relief of chest pain after 60 minutes was reported by 96%. During reperfusion of the infarct-related vessel, an increase in ST-segment deviation was recorded in 61% of the patients, whereas 69% had an increase in chest pain preceding the eventual decline.
Doevendans
P A
PA
Department of Cardiology, Academic Hospital Maastricht, The Netherlands.
Gorgels
A P
AP
van der Zee
R
R
Partouns
J
J
Bär
F W
FW
Wellens
H J
HJ
D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D015425:Myocardial Reperfusion / Q000009:adverse effects; D011237:Predictive Value of Tests; D015912:Thrombolytic Therapy