High frequency QRS electrocardiography in the detection of reperfusion following thrombolytic therapy

The hypothesis that an increase in the amplitude (root-mean-square voltage) of the high frequency (150-250 Hz) components of the QRS complex occurs with successful reperfusion following thrombolytic therapy in acute myocardial infarction (AMI) and fails to occur when thrombolysis fails was tested. C...

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Bibliographic Details
Published in:	Clinical cardiology (Mahwah, N.J.) Vol. 17; no. 4; p. 175
Main Authors:	Aversano, T, Rudikoff, B, Washington, A, Traill, S, Coombs, V, Raqueno, J
Format:	Journal Article
Language:	English
Published:	United States 01-04-1994
Subjects:	Adult Angina Pectoris - physiopathology Cardiac Catheterization Coronary Circulation - physiology Electrocardiography - methods Humans Middle Aged Myocardial Infarction - blood Myocardial Infarction - physiopathology Myocardial Infarction - therapy Myoglobin - blood Streptokinase - therapeutic use Thrombolytic Therapy Tissue Plasminogen Activator - therapeutic use Urokinase-Type Plasminogen Activator - therapeutic use Vascular Patency
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Summary:	The hypothesis that an increase in the amplitude (root-mean-square voltage) of the high frequency (150-250 Hz) components of the QRS complex occurs with successful reperfusion following thrombolytic therapy in acute myocardial infarction (AMI) and fails to occur when thrombolysis fails was tested. Clinical markers for successful or failed reperfusion following thrombolytic therapy for AMI are notoriously insensitive. The amplitude of the high-frequency components of the QRS complex decreases during ischemia and returns to normal with resolution of ischemia, but neither the variability in measurement of these potentials nor their patterns of change during the course of AMI have been described. In 32 control subjects, the average coefficient of variation for the amplitude of the high-frequency QRS complex was 10% or 0.3 uV. Based on these data, for the acute infarction population a significant change in this measurement was therefore defined as a change in amplitude > 20% or 0.6 uV on two consecutive recordings. In 30 patients with AMI treated with a thrombolytic agent, either cardiac catheterization, serial serum myoglobin, or complete resolution of ST-segment elevation were used to define successful or failed reperfusion. High-frequency QRS electrocardiograms were obtained at the start of treatment with a thrombolytic agent and for 3 h thereafter using a signal-averaging technique and digital filtering. Standard 12-lead electrocardiograms were obtained at the same time. In patients who reperfused successfully, the high-frequency QRS amplitude increased significantly (1.2 +/- 0.9 uV above its nadir at 83 +/- 36 min after initiation of thrombolytic therapy) in 23 of 25 patients.
ISSN:	0160-9289
DOI:	10.1002/clc.4960170407