Advertisement

Prevalence and significance of ST-segment alternans during coronary angioplasty

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hellerstein HK
        • Liebow IM
        Electrical alternation in experimental coronary artery occlusion.
        Am J Physiol. 1950; 160: 366-374
        • Joyal M
        • Feldman R
        • Pepine CJ
        ST-segment alternans during percutaneous transluminal coronary angioplasty.
        Am J Cardiol. 1984; 54: 915-916
        • Salerno JA
        • Previtali M
        • Panciroli C
        • Klersy C
        • Chimienti M
        • Bonora MR
        • Marangoni E
        • Falcone C
        • Guasti L
        • Campana C
        • Rondanelli R
        Ventricular arrhythmias during acute myocardial ischaemia in man. The role and significance of R-ST-T alternans and the prevention of ischaemic sudden death by medical treatment.
        Eur Heart J. 1986; 7A: 63-75
        • Sutton PMI
        • Taggart P
        • Lab M
        • Runnalls ME
        • O'Brien W
        • Treasure T
        Alternans of epicardial repolarization as a localized phenomenon in man.
        Eur Heart J. 1991; 12: 70-78
        • Kleinfeld M
        • Stein E
        • Kossmann CE
        Electrical alternans with emphasis on recent observations made by means of a single-cell electrical recording.
        Am Heart J. 1963; 65: 495-500
        • Roselle HA
        • Crampton RS
        • Case RB
        Alternans of the depressed ST-segment during coronary insufficiency.
        Am J Cardiol. 1966; 18: 200-207
        • Hashimoto H
        • Suzuki K
        • Miyake S
        • Nakashima M
        Effects of calcium antagonists on the electrical alternans of the ST segment and on associated mechanical alternans during acute coronary occlusion in dogs.
        Circulation. 1983; 68: 667-672