Implementation of electrocardiography from the coronary sinus in interventional treatment of coronary arteries: two-year experience of clinical application of the method
https://doi.org/10.30629/0023-2149-2020-98-9-10-665-674
Abstract
The aim of this study was to summarize, systematize, and extend analysis of data of two-year clinical use of intracardiac ECG (ECG-CS) in patients with coronary artery disease.
Material and methods. 131 patients with coronary artery disease who underwent a planned coronary stenting were included in a prospective study from 2018 till 2020 . Ischemia was monitored with the use of electrophysiological recording system with the following settings: combining electrodes into fi ve cathode-anode pairs with a frequency range of 30–500 Hz, signal cut-off of 1 cm, and an amplitude of 0.3 mV/cm.
Results. According to the ROC-analysis, the sensitivity of the ECG-СS method in case of ST segment depression was 79.5%, the specifi city was 100%; with ST segment elevation — 83% with a specifi city of 100%, according to data obtained in 88 patients with single-vessel disease of the coronary arteries (CA). Out of 43 patients with coronary artery disease, compromise of the diagonal branch and signifi cant ischemic dynamics (p < 0.05) in the intracardiac lead CS 3–4 after stent placement in the ADA according to ECG-CS was observed in 11 (25.6%) patients, in 9 (20.9%) of which successful provisional stenting was performed, and 2 (4 .6%) patients required implantation of the second stent.
Conclusion. ECG-CS is a promising method for detecting myocardial ischemia in patients with coronary artery disease and allows to optimize intervention in the area of coronary artery bifurcation.
About the Authors
Yu. L. Shevchenko
Institute for Additional Training of Doctors of Pirogov National Medical and Surgical Center
Russian Federation
Russian Federation
105203, Moscow
D. Yu. Ermakov
Institute for Additional Training of Doctors of Pirogov National Medical and Surgical Center
Russian Federation
Russian Federation
Ermakov Dmitry Yuryevich — graduate student
105203, Moscow
D. I. Marchak
Institute for Additional Training of Doctors of Pirogov National Medical and Surgical Center
Russian Federation
Russian Federation
105203, Moscow
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Review
For citations:
Shevchenko Yu.L., Ermakov D.Yu., Marchak D.I. Implementation of electrocardiography from the coronary sinus in interventional treatment of coronary arteries: two-year experience of clinical application of the method. Clinical Medicine (Russian Journal). 2020;98(9-10):665-674. (In Russ.) https://doi.org/10.30629/0023-2149-2020-98-9-10-665-674
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