ANALYSIS OF VENTRICULAR ACTIVATION IN PATIENTS WITH CHRONIC NON-Q-WAVE MYOCARDIAL-INFARCTION - COMPARISON WITH LEFT-VENTRICULAR ASYNERGY AND MYOCARDIAL PERFUSION DEFECTS

In this report, we dealt with ventricular activation abnormalities in 30 patients with previous non-Q myocardial infarction (MI) by means of the CARDIAG 128.1 device, which enables analysis of ECGs, VCGs and bo dy surface potential maps. The diagnosis was verified by left ventricu lography, echocardiography and perfusion scintigraphy. Twenty-nine hea lthy subjects served as the control group. Morphological findings conf irmed the presence of a significant subgroup with serious left ventric ular asynergy. Seven electrocardiological variables, which significant ly differed from control values, disclosed that non-Q MI is responsibl e for localized activation time prolongation, and that inferoposterior scars tend to delay the entire activation of ventricles, and to cause disturbances of the terminal depolarization phase together with a dec rease in voltage production during QRS. Lesions of the anterior wall a nd the apicomesial part of the inferoposterior wall affect the distrib ution of the Q wave more often than the posterior basal ones. The prob ability of such abnormalities increases with the degree of asynergy. S ome VCG criteria increase the sensitivity of electrocardiological anal ysis. These parameters will be used for evaluating the diagnostic valu e of electrocardiological analysis in the chronic non-Q MI. Non-Q myoc ardial infarctions represent a heterogeneous group of infarctions from both electrophysiological and morphological aspects.