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Distribution of Significant Changes in QRST Area Compared to Supraventricular Complex
Author(s) -
SUZUKI AKIRA,
HIRAI MAKOTO,
HAYASHI HIROSHI,
ICHIHARA YOSHIO,
ADACHI MASAYOSHI,
OGUCHI SADAO,
NISHIYAMA ATSUSHI,
SHIMIZU SEIJI,
WATARAI MASATO,
SHIGA YUKIO,
FURUTA TATSUJI,
TAKATSU FUMIMARO
Publication year - 1993
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1993.tb01655.x
Subject(s) - medicine , cardiology , sinus rhythm , supraventricular arrhythmia , myocardial infarction , coronary sinus , normal sinus rhythm , atrial fibrillation
To assess the effects of right ventricular (RV) pacing on body surface QRST distributions, we recorded QRST isointegral mops (I‐maps) during sinus rhythm and RV pacing in 25 patients with anterior myocardial infarction (MI), 19 with inferior MI, and 14 without MI. The QRST values at each lead point recorded during sinus rhythm and RV pacing with an 87‐lead system were analyzed with a paired t‐test in each patient. An abnormal decrease in the QRST value of the I‐map was assessed by the difference map, which indicated a −“2SD area,” where the QRST integral value was less than the normal range (mean – 2SD) caiculated from 608 normal individuais. The I‐maps were similar during the two activation sequences in patients with and without MI. However, during RV pacing, QHST values significantly decreased over the upper right anterior chest and increased over the lower left anterior chest and back. The ΣDMs (sum of QRST integral vaiues beiow the normal range) for both activation sequences were strongly correlated in patienis with anterior MI and with inferior MI (r = 0.91 and r = 0.92, respectively; P < 0.001). Although small but significant changes in QRST values were detected, the distribution of the “‐2SD area” and the ΣDM were similar during both activation sequences in patients with prior MI. Thus, these findings demonstrate that an altered activation sequence produces small but significant changes in QRST values but that I‐maps still provide information that is useful for the diagnosis of MI during RV pacing.