VECTORCARDIOGRAPHIC MONITORING TO ASSESS EARLY VESSEL PATENCY AFTER REPERFUSION THERAPY FOR ACUTE MYOCARDIAL-INFARCTION

Reperfusion therapy has lowered mortality in patients suffering from a cute myocardial infarction. Failure to reperfuse is associated with an increased short- and long-term mortality. In a prospective study we u sed dynamic vectorcardiography to monitor 96 patients with acute myoca rdial infarction treated with reperfusion therapy to non-invasively as sess coronary patency. The results from om continuous monitoring were compared to those obtained from angiography. By using trend-analysis o f QRS vector difference and ST vector magnitude, we were able to corre ctly identify 58 of the 70 patients (83%) with a reperfused infarct-re lated artery, and 19 of the 26 patients (73%) with a persistently occl uded artery demonstrated at an early angiogram (diagnostic accuracy 80 %). In patients with high-grade collateral flow to the infarct-related area the results of the vectorcardiographic monitoring and of angiogr aphy showed the largest disagreement, whereas the accuracy of vectorca rdiographic monitoring was high: 88% among patients without collateral s. Tire present results suggest that QRS complex and ST segment vector cardiographic monitoring is a useful tool for assessing early coronary artery patency, and that dynamic vectorcardiography may help in ident ifying candidates for emergency coronary angiography.