ASSESSMENT OF REPERFUSION IN MYOCARDIAL-INFARCTION BY BODY-SURFACE ELECTROCARDIOGRAPHIC MAPPING

To determine the efficacy of body surface potential mapping to detect and quantify reperfusion in acute infarction, 66 patients were studied by repeated body surface potential mapping before and after administr ation of the thrombolytic agent. The QRS and ST-segment were analyzed and compared to the arterial patency as assessed by arteriography with in 10 days. The infarct-related vessel was patent in 50 patients and o ccluded in the remaining 16. In 6 of the 15 patients in whom thromboly tic therapy was started within 2 hours of the onset of chest pain the ST-segment changed from that of an acute infarction pattern to that of a normal pattern, and the QRS pattern either remained normal or recov ered prior to discharge. In two additional patients the QRS pattern re turned to normal prior to discharge from the hospital. In the 51 patie nts with later thrombolytic therapy (greater-than-or-equal-to 2 hours) the degree of ST elevation and depression decreased more than either the control infarction group (36 inferior and 73 anterior patients) or the group in whom reperfusion attempts were unsuccessful, but the pat tern of the map remained that of an infarction. The QRS maps showed th at in the first 48 hours recovery of potential was insufficient to dis tinguish those with successful thrombolysis. Early reperfusion could b e detected by body surface potential mapping and the eventual damage p redicted from the degree of change in the QRS map. Later reperfusion c ould be surmised but not quantified.