A quantitative evaluation of ST-segment changes on the 18-lead electrocardiogram during acute coronary occlusions

Abstract

This study determined quantitative ST segment changes on the 18-lead electrocardiogram (ECG) during occlusions in each of the coronary arteries. Methods Continuous 18-lead ECGs, including standard 12 leads, posterior (V 7-9), and right ventricular (RV) leads (V 3-5R) were recorded for 155 subjects undergoing percutaneous coronary occlusions, the maximum intervention. Results During 58 left anterior descending (LAD) coronary occlusions, the maximum ST elevation and depression were in V 3 (4.2mm) and III (−0.9mm), respectively. During 44 right coronary artery (RCA) occlusions, the maximum ST elevation and depression were in III (2.2mm) and aVL (−1.4mm), respectively. During 53 left circumflex (LCX) occlusions, the maximum ST elevation and depression were in V 7 (0.8mm) and V 2 (−1.6mm), respectively. Conclusions ST elevation often occurred in the anteroapical (V 1-V 6), lateral (I, aVL), and RV lead V 3R during LAD occlusions; in the inferior, RV, and posterior leads during RCA occlusions; and in the posterior, inferior, and apical leads (V 5-V 6) during LCX occlusions.