Electromechanical assessment of left ventricular function following successful percutaneous coronary revascularization

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.