QRS prolongation: A sensitive marker of ischemia during percutaneous transluminal coronary angioplasty

The purpose of this study is to measure QRS duration changes in the human m odel of ischemia during percutaneous transluminal coronary angioplasty (PTC A) and compare these results to the commonly used ischemia markers, chest p ain, and classical ST-T changes. Using a computerized method, QRS duration was measured in 51 patients undergoing elective PICA. Three milliseconds (m sec) or more prolongation of the QRS at peak inflation was considered to be an ischemic response, The results were compared to chest pain and ST-T cha nges and were analyzed for inflation site within individual coronary arteri es. Forty-two patients had a pathological prolongation of the QRS during PI CA. Thirty-two patients developed chest pain, while 19 had ischemic ST-T ch anges. QRS duration was more prolonged in PTCA to proximal or middle segmen ts of major arteries or their large branches, while it was less prolonged i n distal segments or smaller branches. Using our method, QRS prolongation w as an ischemia marker in most patients during PICA and was more sensitive t han chest pain or ST-T changes. QRS duration was more prolonged with occlus ion of proximal and middle segments of major arteries. (C) 2000 Wiley-Liss, Inc.