Electrocardiographic ST-segment monitoring during controlled occlusion of coronary arteries

Haeberlin, Andreas; Studer, Evelyn; Niederhäuser, Thomas; Stoller, Michael; Marisa, Thanks; Goette, Josef; Jacomet, Marcel; Traupe, Tobias; Seiler, Christian; Vogel, Rolf

doi:10.1016/j.jelectrocard.2013.10.003

Cited by 9 publications

(8 citation statements)

References 28 publications

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“…In contrast to previous studies emphasizing the LCx as the vessel most commonly to present as totally occluded without ST-segment elevation, 20,21 in the present study, an RCA culprit vessel had the highest likelihood of being totally occluded in the setting of NSTEMI. This may reflect the greater sensitivity of physicians to recognize anterior ST-segment depression in the patient with ongoing symptoms as a medical emergency, thereby not enrolling them in ACUITY.…”

Section: Discussioncontrasting

confidence: 99%

Incidence and Impact of Totally Occluded Culprit Coronary Arteries in Patients Presenting With Non–ST-Segment Elevation Myocardial Infarction

Warren

Mehran

et al. 2015

The American Journal of Cardiology

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Section: Discussioncontrasting

confidence: 99%

Incidence and Impact of Totally Occluded Culprit Coronary Arteries in Patients Presenting With Non–ST-Segment Elevation Myocardial Infarction

Warren

Mehran

et al. 2015

The American Journal of Cardiology

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“…Similarly, if an initial 12lead ECG demonstrates that a particular lead suggests ischemia, that same lead should be prioritized for continuous ischemia monitor ing. Recommendations have differed over the years as to which lead is of most benefit in identifying ischemia in the circumflex artery: I, aVL, V 5 or V 6 41 ; III or aVF 15 ; or V 6 for STsegment elevation and V 1 and V 3 for ST segment depression 42 in the circumflex. The disagree ment may be attributable to heterogeneity of study samples, with ischemia in distal versus proximal areas of the circumflex artery and either elevation or depres sion of the ST segment.…”

Section: Appropriate Lead Selectionmentioning

confidence: 99%

“…Primary repolarization abnormalities occur indepen dently, without changes in QRS depolarization, 40,42 and include the following:…”

Section: Nonischemic Causes Of St-segment Changesmentioning

confidence: 99%

“…They occur with changes in sequence or duration of ventricu lar depolarization 40,42 and include the following: • Right or left BBB • Paced rhythms • Ventricular hypertrophy • Ventricular preexcitation Several other patient populations that present with electrocardiographic waveforms displaying abnormal re polarization are particularly challenging for the clinician on initial admission to the hospital if the patient's history is not well known and no baseline ECG is available. Expert consultation may be indicated.…”

Section: Nonischemic Causes Of St-segment Changesmentioning

confidence: 99%

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Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

198

214

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Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

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“…In suspected ACS, selection of leads monitoring these regions is therefore suggested; leads III and V3 are common choices (Collins, 2010). In a study using experimental coronary artery occlusion, ST elevation was greatest in these two leads, although aVF had the greatest sensitivity and specificity for right coronary artery occlusion (Haeberlin et al, 2014).…”

Section: St-segment Monitoringmentioning

confidence: 99%

Continuous ECG monitoring in hospital: part 2, practical issues

Sampson

2018

British Journal of Cardiac Nursing

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Continuous monitoring of the electrocardiogram (ECG) is a common intervention performed by cardiac nurses. In the first article of this two-part series, we evaluated the principal indications for ECG monitoring. These are the detection of arrhythmias, monitoring for myocardial ischaemia, and measurement of the QT interval. In this second article, the practical issues surrounding ECG monitoring are evaluated. The use of 3-and 5-electrode systems is discussed, and is related to ECG theory and normal coronary artery anatomy. Recommendations are made for lead selection, correct electrode placement, and the recording of 12-lead ECGs. The article concludes with a consideration of safe practice in respect of alarm management, and considers both individual and organisational approaches to reducing inappropriate alarms.

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Electrocardiographic ST-segment monitoring during controlled occlusion of coronary arteries

Cited by 9 publications

References 28 publications

Incidence and Impact of Totally Occluded Culprit Coronary Arteries in Patients Presenting With Non–ST-Segment Elevation Myocardial Infarction

Incidence and Impact of Totally Occluded Culprit Coronary Arteries in Patients Presenting With Non–ST-Segment Elevation Myocardial Infarction

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Continuous ECG monitoring in hospital: part 2, practical issues

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