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Application of an Electrocardiographic Inverse Solution to Localize Ischemia During Coronary Angioplasty
Author(s) -
MACLEOD ROBERT S.,
GARDNER MARTIN,
MILLER ROBERT M.,
HORÁC̆UEK B. MILAN
Publication year - 1995
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1995.tb00752.x
Subject(s) - medicine , cardiology , angioplasty , myocardial ischemia , ischemia , electrocardiography
Localization of Ischemia. This study demonstrates the utility of an electrocardiographic Localization of Ischemia. This study demonstrates the utility of an electrocardiographic Inverse solution, coupled with body surface potential mapping (BSPM), in localizing acute ischemia in patients undergoing percutaneous transluminal coronary angioplasty (PTCA). PTCA balloon inflations produce complete occlusion and acute transient ischemia, which can be detected electrocardiographically with BSPM. Comparisons between maps recorded both during and before the inflation of the PTCA balloon allow patient‐ and artery‐specific characterizations of the resulting ischemia. Knowledge of the patient's coronary anatomy and the location of the occlusion site by coronary angiography permit an estimation based on cardiac hemodynamics of the region of myocardium most likely to suffer from PTCA‐induced ischemia. Electrocardiographic inverse solutions provide a means of predicting cardiac potentials from body surface maps. In this study, we describe an inverse solution we have developed to localize the transient ischemia produced by PTCA. To validate the procedure, we compared the locations of predicted ischemia in seven patients with a qualitative estimate of the perfusion region based on fluoroscopic examination of each patient's coronary anatomy and PTCA balloon location. In each case, the region of ischemia predicted by the model included the perfusion zone determined fluoroscopically. These results suggest that electrical changes induced by acute ischemia can be localized with an electrocardiographic inverse solution.