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  • Title: Electrocardiographic ST-segment monitoring during controlled occlusion of coronary arteries.
    Author: Haeberlin A, Studer E, Niederhauser T, Stoller M, Marisa T, Goette J, Jacomet M, Traupe T, Seiler C, Vogel R.
    Journal: J Electrocardiol; 2014; 47(1):29-37. PubMed ID: 24238737.
    Abstract:
    BACKGROUND: Ischemia monitoring cannot always be performed by 12-lead ECG. Hence, the individual performance of the ECG leads is crucial. No experimental data on the ECG's specificity for transient ischemia exist. METHODS: In 45 patients a 19-lead ECG was registered during a 1-minute balloon occlusion of a coronary artery (left anterior descending artery [LAD], right coronary artery [RCA] or left circumflex artery [LCX]). ST-segment shifts and sensitivity/specificity of the leads were measured. RESULTS: During LAD occlusion, V3 showed maximal ST-segment elevation (0.26mV [IQR 0.16-0.33mV], p=0.001) and sensitivity/specificity (88% and 80%). During RCA occlusion, III showed maximal ST-elevation (0.2mV [IQR 0.09-0.26mV], p=0.004), aVF had the best sensitivity/specificity (85% and 68%). During LCX occlusion, V6 showed maximal ST-segment elevation (0.04mV [IQR 0.02-0.14mV], p=0.005), and sensitivity/specificity was (31%/92%) but could be improved (63%/72%) using an optimized cut-off for ischemia. CONCLUSION: V3, aVF and V6 show the best performance to detect transient ischemia.
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