CONTINUOUS 3-DIMENSIONAL VECTORCARDIOGRAPHY, A VALUABLE TOOL FOR ONLINE ISCHEMIA MONITORING

By using the complete 3-dimensional electrocardiographic information, continuous vectorcardiography offers better insights into ischemic eve nts in the lateral and inferior parts of the heart than the 12-lead EG G. In addition, by using other components of the ECG curve, such as QR S-complex changes, it also provides more sensitive markers of ischemia than mere ST-segment deviations, ST-segment changes and QRS-complex c hanges are registered in the three orthogonal leads and each parameter is condensed into one variable, averaging the root square of the sum of the second power of the absolute values, The result is continuously updated and displayed as a treadcurve which offers realtime ischemia monitoring, This capability is valuable for both the non-invasive asse ssment of the acute ischemic burden during PTCA and for ischemia monit oring in the critical 24 h thereafter where the hazard of reocclusion is highest. Continuous vectorcardiography also serves as a powerful to ol in the non-invasive assessment of infarct artery patency after thro mbolysis and can help to identify patients with persistent occlusion a nd reocclusion after primary successful procedures who thereby qualify for rescue PTCA, By using 3D-vectorcardiography on-line ischemia moni toring in patients with unstable angina for risk stratification is als o feasible.