The relationship between T-wave peak-to end interval and ST segment recovery on intracoronary ECG during primary PCI

A. Elitok, B. Ikitimur, I. Onur, F. Oz, S. Emet, E.B. Karaayvaz, N.G. Serbest, R. Sarikaya, K. Kasali, A.K. Bilge, M.G. Kaya, F. Mercanoglu, H. Oflaz

Department of Cardiology, Istanbul University, School of Medicine, Istanbul, Turkey. samim03@hotmail.com

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• Cardiology

OBJECTIVE: T-wave peak to end interval (TPE) is a measure of repolarization dispersion, which has been reported as a major arrhythmogenic factor post acute myocardial infarction. The aim of our study was to investigate the changes in TPE in this patient population with regard to peri-procedural intracoronary ECG findings.

PATIENTS AND METHODS: Forty-four patients (34 male and mean age of 54.9 ± 10.9 years) with acute STEMI were included. Intracoronary ECG was performed during primary PCI. TPE indices were calculated before and after the procedure. Measurement of the intracoronary ST-segment was carried out before and just after coronary blood flow was established in the infarct related artery. Intracoronary ST-segment resolution (IC-STR) was defined as ≥ 1 mm compared to baseline.

RESULTS: There was no difference with respect to baseline characteristics when patients with IC-STR were compared with patients without IC-STR. TPE values decreased significantly after primary PCI in patients with IC-STR (80.9 ± 22.8 ms vs. 65.8 ± 14.4 ms; p < 0.001) whereas they did not change significantly after PCI in patients without IC-STR (79.2 ± 20.9 ms vs. 68.5 ± 16.3 ms; p = 0.18).

CONCLUSIONS: TPE measured from surface ECG recordings is significantly reduced in STEMI patients with successful reperfusion after primary PCI, as determined by IC-ECG recordings.

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