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KMID : 0882420160900010026
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Korean Journal of Medicine
2016 Volume.90 No. 1 p.26 ~ p.31
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Comparison of the Signal-averaged ECG after Primary Percutaneous Coronary Intervention according to Thrombus Aspiration in ST Elevation Myocardial Infarction
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이준영:Lee Jun-Young
최원석:Choi Won-Suk/정병천:Jung Byung-Chun/이봉렬:Lee Bong-Ryeol/강현재:Kang Hyun-Jae/김재희:Kim Jae-Hee/강균은:Kang Gyoun-Eun
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Abstract
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Background/Aims: Percutaneous coronary intervention (PCI) is the standard method of treating ST-segment elevation myocardial infarction (STEMI). There is continuing uncertainty as to whether reducing the thrombus burden through catheter aspiration improves the arrhythmogenic structure of the myocardium in STEMI. We compared the changes in electrical instability after thrombus aspiration-assisted primary PCI using conventional primary PCI.
Methods: The study population included 170 consecutive patients with STEMI who underwent primary PCI. The patients were divided into 80 patients who underwent primary PCI only and 90 patients who underwent thrombus aspiration before PCI. The signal-averaged ECG (SAECG) was obtained 5 ± 2 days after the intervention.
Results: There were no significant differences between the groups in terms of sex, age, cardiovascular risk factors, or time from the onset of symptoms to treatment. The duration of the low amplitude signals less than 40 μV (LAS40), duration of the QRS complex (QRSD), and root mean square voltage of the terminal 40 ms of the QRS complex (RMS40) did not differ between the thrombus aspiration and no thrombus aspiration groups. The incidences of QRSD > 114 ms and RMS40 < 20 μV were significantly lower in the thrombus aspiration group than the no thrombus aspiration group (19 vs. 8, p = 0.011 and 16 vs. 8, p = 0.047, respectively), while the incidence of LAS > 38 ms was significantly higher in the non-thrombus aspiration group (18 vs. 8, p = 0.018).
Conclusions: Among random patients with STEMI, thrombus aspiration improved all of the parameters of SAECG, which is related to ventricular arrhythmogenesis, although the long-term clinical outcomes need to be assessed.
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KEYWORD
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Thrombectomy, Electrocardiography, Myocardial infarction
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