Kc. Koch et al., Electromechanical assessment of left ventricular function following successful percutaneous coronary revascularization, CATHET C IN, 54(4), 2001, pp. 466-472
Percutaneous electromechanical mapping was applied to evaluate the impact o
f coronary revascularization on electrical and mechanical parameters in pat
ients with prior myocardial infarction. In 15 patients with prior (greater
than or equal to 4 weeks) myocardial Q-wave infarction and regional wall mo
tion abnormalities, left ventricular endocardial mapping was performed imme
diately prior to percutaneous coronary revascularization. Patients underwen
t repetitive mapping during 6-month follow-up angiography with good revascu
larization results in all patients. Mean regional unipolar electrogram (UP)
amplitude of all regions remained unchanged (10.4 +/- 4.2 mV prerevascular
ization vs. 10.2 +/- 4.4 mV postrevascularization), whereas mean local shor
tening (LS) of all regions increased from 6.0% :+/- 5.8% to 9.7% +/- 5.3% (
P < 0.001). The percentage of electromechanical match regions (LS < 6% and
UP < 9 mV) remained unchanged after revascularization (15% vs. 10%; NS), wh
ereas the percentage of mismatch regions (LS < 6% and UP <greater than> 9 m
V) declined from 38% to 10% (P < 0.0001). We conclude that electromechanica
l mapping allows the sensitive detection of improved mechanical function af
ter successful revascularization. Electrical activity remains unchanged 6 m
onths after revascularization and the number of regions with an electromech
anical mismatch decrease. (C) 2001 Wiley-Liss, Inc.