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This study was designed to determine the intra-operative incidence of right-sided ventricular ischaemia and any association with left ventricular ischaemia. In 60 patients, undergoing coronary artery bypass grafting surgery, a right-sided precordial lead V5R was used. ST segment deviation of more than 1 mm in V5R was considered significant for myocardial ischaemia. Right ventricular ischaemia occurred in 14 patients (23.3%) but was not associated with left ventricular inferior wall ischaemia. In 4 patients (6.6%) presenting with right ventricular ischaemia, ischaemia of the left inferior wall also developed but in all cases was transient and disappeared by the end of surgery. No myocardial infarction was detected in the post-operative period. The present study showed that the use of a right-sided lead may improve intra-operative electrocardiographic monitoring, by revealing ischaemia in those patients in whom ECG abnormalities were not detected by conventional leads. The transient right ventricular ischaemia recorded in this study was probably related to a reduced hypothermic protection of the right ventricle during aortic cross clamping.

Detection of right ventricular ischaemia during coronary surgery by means of a right precordial leadSummary sient and disappeared by the end of surgery. No myocardial infarction was detected in the post-operative This study was designed to determine the intra-opperiod. The present study showed that the use of a erative incidence of right-sided ventricular ischaemia right-sided lead may improve intra-operative electroand any association with left ventricular ischaemia. cardiographic monitoring, by revealing ischaemia in In 60 patients, undergoing coronary artery bypass those patients in whom ECG abnormalities were not grafting surgery, a right-sided precordial lead V5R was detected by conventional leads. The transient right used. ST segment deviation of more than 1 mm in V5R ventricular ischaemia recorded in this study was probwas considered significant for myocardial ischaemia.ably related to a reduced hypothermic protection of Right ventricular ischaemia occurred in 14 patients the right ventricle during aortic cross clamping. (23.3%) but was not associated with left ventricular inferior wall ischaemia. In 4 patients (6.6%) presenting Keywords: ischaemia, right ventricle, coronary with right ventricular ischaemia, ischaemia of the left surgery. inferior wall also developed but in all cases was tran-