CAPABILITIES FOR THE PREDICTION OF ACUTE MYOCARDIAL INFARCTION BY 12-CHANNEL DYNAMIC ELECTROCARDIOGRAM MONITORING
Background: 12 lead ECG monitoring, especially in continuing pain syndrome, allows to predict the course of myocardial infarction, the possibility of its recurrence.
Aim: to study the dynamic state of ST segment in patients with acute myocardial infarction in the first-second day to evaluate the effectiveness of therapy including systemic thrombolysis.
Materials and methods: 25 patients were between the ages of 27 to 82 years (mean age 68 years) diagnosed with acute myocardial infarction who continued feeling of discomfort in the heart during the first days of stay in the hospital. All patients underwent systemic thrombolysis.
Analysis of the ST segment of ECG monitoring was using «Kardiotehnika-04-8(M)» “Inkart» (St.-Petersburg) in standard 12 leads.
Results and discussion: 20 patients have significant ST segment offsets have been recorded. In the course of the disease in these patients was stable, recurrence or complications was not current.
2 patients have registered frequent episodes of ischemic ST-segment depression in initially changed leads, 2 patients with persistent ST segment depression in lead that characterize the area of infarction, recorded episodes of transient depression in the lead on an adjacent wall. In both cases, patients developed recurrence of myocardial infarction with diffusion zones defects.
In another case, a patient 27 years, mostly at night, registered 9 episodes, ST segment elevation in leads V2 and V6 up to 4-6 mm in length from 2 to 6 minutes, typical of vasospastic angina Princmetalla. During the ischemic ST-segment elevation registered frequent polymorphic ventricular extrasystoles, episodes of unstable ventricular tachycardia, including torsades de pointes. Following the appointment of antagonists calcium therapy of ischemic ST segment offsets, the ventricular arrhythmias were recorded.
Conclusions: the 12-channel ECG Holter admittedly highly informative to evaluate the effectiveness of therapy of acute myocardial infarction, including systemic thrombolysis. Data may be used for the selection of patients for reconstructive surgeries on coronary arteries.