Original ArticlesContinuous Monitoring of Global Left Ventricular Ejection Fraction During Percutaneous Transluminal Coronary Angioplasty 1
Section snippets
Patients
All patients referred for elective PTCA were eligible for the study.
Exclusion criteria were cardiac arrhythmia, LVEF <35%, LV hypertrophy on electrocardiogram, left bundle branch block, or a prior coronary artery bypass graft. The study population comprised 50 patients. Of these, 5 were excluded because of arrhythmia during the PTCA procedure; 3 had poor radioactive blood labeling, and in 2 patients positioning of the detector was not possible because the detector interfered with the x-ray
Left Ventricular Function
Fig. 1 shows typical examples of the effect of a single balloon inflation on the LVEF in 3 patients undergoing dilation of the left anterior descending artery, the circumflex artery, and the right coronary artery, respectively. Average values of the LVEF, LV end-diastolic counts, LV end-systolic counts, and heart rate during the PTCA procedure in the total population are given in Table I.
Insertion of the guidewire in the coronary artery was associated with a mean rise of 0.04 EF units (7%) in
The Cardioscint
The advantage of the Cardioscint system for LV monitoring during PTCA is the small size and high sensitivity of its detector. Once positioned, the system can monitor global LV function continuously with a temporal resolution of 10 ms, thus yielding an unusual opportunity for analyzing the effect of acute transient occlusion of a coronary artery on global LV function. In the present study the main problem in using the Cardioscint system was that fluoroscopy interfered with the detector’s
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This study was supported by the Danish Heart Foundation, Copenhagen, Denmark; and the Laerdal Foundation for Acute Medicine, Stavanger, Norway.