Intracoronary Electrocardiogram Recording With a Bare-Wire System. Perioperative ST-Segment Elevation in the Intracoronary Electrocardiogram Is Associated With Myocardial Injury After Elective Coronary Stent Implantation

Tadayuki Uetani, Tetsuya Amano, Soichiro Kumagai, Hirohiko Ando, Kiminobu Yokoi, Tomohiro Yoshida, Bunichi Kato, Masataka Kato, Nobuyuki Marui, Michio Nanki, Tatsuaki Matsubara, Hideki Ishii, Hideo Izawa, Toyoaki Murohara

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Objectives: With an intracoronary electrocardiogram (IcECG) recording with insulated polymer-coated guidewire without balloon catheter, we sought to examine the association between ST-segment elevation in the IcECG after elective stenting and myocardial injury. Background: An IcECG is a sensitive method to detect local myocardial ischemia. Occasionally, persistent ST-segment elevation in the IcECG was recorded after successful coronary intervention. Conventionally IcECG was recorded with a guidewire and over-the-wire system. Methods: Patients who underwent elective stenting were enrolled (n = 339). The IcECG both at baseline and after procedure were obtained with a guidewire with an insulating coated shaft suitable for IcECG recording. The presence of chest pain after percutaneous coronary intervention was recorded. Cardiac biomarkers were examined 18 h after the procedure. Results: The ST-segment elevation in the IcECG after procedure was recorded in 65 patients, and no change was recorded in 274 patients. Troponin-T, creatine phosphokinase, and creatine kinase MB isoform after the procedure were significantly higher in patients with post-procedural ST-segment elevation in the IcECG than patients without ST-segment elevation. Multivariate analysis demonstrated that ST-segment elevation in the IcECG is an independent predictor of post-procedural myocardial injury. The incidence of ST-segment elevation in the IcECG was significantly higher in patients with post-procedural chest pain than patients without chest pain (p < 0.001). Conclusions: We demonstrated a facile method to record IcECG with a guidewire with a polymer-coated shaft. The IcECG is a useful method for predicting post-procedural myocardial injuries.

Original languageEnglish
Pages (from-to)127-135
Number of pages9
JournalJACC: Cardiovascular Interventions
Issue number2
Publication statusPublished - 01-02-2009


All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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