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- Dellborg, M, et al.
(författare)
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ECG changes during myocardial ischemia. Differences between men and women
- 1995
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Ingår i: Journal of Electrocardiology. - : Churchill Livingstone. - 0022-0736 .- 1532-8430. ; 27:suppl., s. 42-45
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Tidskriftsartikel (refereegranskat)abstract
- Women have a higher short-term mortality in acute myocardial infarction (MI) compared with men. This may be partly explained by differences in risk factors such as age and diabetes. However, several reports have focused on the occurrence of a sex bias making women less likely to be subjected to angiography and revascularization as well as aggressive pharmacologic treatment of acute MI. The decision to initiate these procedures is often based on ischemic changes of the electrocardiogram. It was therefore investigated whether differences between men and women in magnitude of electrocardiographic changes during myocardial ischemia could explain some of the differences previously reported. A total of 178 patients with chest pain suggestive of MI (135 men and 43 women) included in a study of thrombolytics were monitored for 24 hours with continuous vectorcardiography. Also, 81 patients with stable angina pectoris undergoing elective angioplasty were monitored during the procedure. In patients admitted with suspicion of MI, the initial summated ST deviation was 178 +/- 146 microV for men as compared with 105 +/- 91 microV for women (P = .002). During angioplasty, men had significantly more pronounced maximum ST deviation during inflation of the balloon (235 +/- 165 vs 156 +/- 89 microV; P = .036). In conclusion, men have more pronounced ST changes than women during myocardial ischemia. When fixed magnitudes of ST deviation are required for initiating therapy such as thrombolytics, this will favor treatment of men. A sex-adjusted limit for administrating thrombolytic drugs may be warranted in the light of the above findings.
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| 3. |
- Ingemansson, Max, et al.
(författare)
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Modification of intrinsic AV-nodal properties by magnesium in combination with glucose, insulin, and potassium (GIK) during chronic atrial fibrillation
- 1998
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Ingår i: Journal of Electrocardiology. - 1532-8430. ; 31:4, s. 281-292
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore the effects of MgSO4 in combination with glucose, insulin, and potassium (GIK) on intrinsic AV-nodal properties during chronic atrial fibrillation. METHODS: The study included two patient groups--(a) control and intervention and (b) intervention--with different infusion times and concentrations of MgSO4. Ambulatory electrocardiographic recordings were analyzed using modified heart-rate stratified histogram (HRSH) analysis allowing detailed observation of the RR distribution at different average heart rate levels. The two RR-interval populations observed in most patients were characterized by analyzing the relationship between the summits of the peaks of the bimodal histograms. RESULTS: A bimodal RR distribution with a shorter and a longer RR-interval population was observed in 9 of 11 (control), 9 of 11 (intervention) in group (a), and 11 of 13 in group (b) patients. No significant changes in the two RR populations were seen in the control registration (group a). There were, however, indications of a conduction delay in the longer RR intervals in group (a), which received a low concentration of MgSO4, when control was compared with intervention recordings. In group (b), receiving a high MgSO4 concentration, a conduction delay was seen in both the shorter and longer RR populations, being most pronounced for the longer RR population. CONCLUSION: High MgSO4 levels caused a delay in both the shorter and longer RR intervals. The conduction delay in the longer RR population was most pronounced, indicating that MgSO4 differently affected the two corresponding AV-nodal pathways.
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| 4. |
- Pahlm, U S, et al.
(författare)
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The standard 11-lead ECG. Neglect of lead aVR in the classical limb lead display
- 1996
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Ingår i: Journal of Electrocardiology. - 1532-8430. ; 29 Suppl, s. 270-274
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates how the format of limb lead display influences electrocardiographic (ECG) interpretation. The positive aspect of lead aVR (included in the classical display) is directed opposite to that of the other leads. This could lead to an ECG interpreter's disregard of lead aVR, thus providing a "standard 11-lead ECG." It is hypothesized that when using the classical limb lead display, ECG interpreters often ignore lead aVR, even when considering complex ECGs. Thirty-five of the participants attending this International Society of Computerized Electrocardiology meeting were asked to interpret five complex ECGs, displayed in the classical format. Lead aVR had been replaced by lead -aVR on all of these recordings. Second, the participants were asked if they (1) used all 12 leads, (2) used lead aVR, and (3) noticed that lead aVR had been changed. The results indicate that a vast majority of interpreters (80-94%) did not detect when lead aVR had been reversed. This suggests that interpreters only use 11 of the standard leads when presented with the classical display method to evaluate clinical problems.
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