Prevalence and significance of ST-segment alternans during coronary angioplasty

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      Electrical alternans is a phenomenon of alternating electrocardiographic morphology on an every-other-beat basis. ST-segment alternans is often seen in the animal laboratory with subtotal or transient coronary artery occlusion.1 In humans it has been observed in a variety of settings, such as Prinzmetal's angina and once during percutaneous transluminal coronary angioplasty (PTCA).2 Although clinically rarely observed, ST-segment alternans has been correlated with subsequent malignant arrhythmias and may be an important marker of electrically unstable myocardium.3 This study was performed to determine whether PTCA-induced transmural ischemia could reproducibly induce ST-segment alternans and serve as a model for this syndrome.
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