[Electrocardiographic diagnosis of ischemic lesions of the myocardium in patients with artificial pacemaker].
137 patients with artificial cardiac pacemaker (ACP) were examined to ascertain origin and changes of the end of spontaneous ventricular complexes (SVC) in ventricular pacing. The examination program included the ACP inhibition test, K test, veloergometry (VEM), echocardiography. Intermittent pacing has revealed depression of ST segment and/or inversion of T wave of SVC in 109 (79.6%) patients. After inhibition (switch off) of ACP in spontaneous heart rhythm 45 (41.3%) patients got free of the above shifts or showed a less number of pathological ECG leads (Chaterie's syndrome). In positive K test conducted after inhibition of ACP normalization of the SVC end in additional 11.0% cases. True Chaterie's syndrome is characterized by reversibility of ST wave depression and/or inversion of T wave of SVC in long spontaneous rhythm and a positive potassium test. In ischemic damage to the myocardium or postinfarction scars, changes of the SVC end part were stable, combined in many cases with pathological changes of QRS-complex, positive VEM test. Hyperdiagnosis of microfocal myocardial infarction in intermittent ventricular pacing was observed in 78% cases, especially due to Chaterie's syndrome. Thus, analysis of ECG changes is important for the choice of a valid policy of management of patients with ACP.
Iskenderov
B G
BG
Lokhina
T V
TV
D000368:Aged; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology*; D010138:Pacemaker, Artificial; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000503:physiopathology
Vozmozhnosti élektrokardiograficheskoĭ diagnostiki ishemicheskikh porazheniĭ miokarda u bol'nykh s iskusstvennym voditelem ritma serdtsa.