ECG-Based Characterization of Acute Ischemia During Percutaneous Coronary Intervention

Ischemic heart disease is the leading cause of death in the world. Its diagnosis involves monitoring of the dynamic changes in the ST segment of the ECG, although changes in other intervals and waves of the ECG have been observed. Our aim was to quantify the changes in the ECG ventricular depolarization and repolarization during acute myocardial ischemia. 12-lead ECG recordings acquired during and prior the acute ischemia induced by percutaneous coronary intervention (PCI) in one of the three main coronary arteries were analyzed. Averaged heart-beats were computed and ECG depolarization and repolarization features were extracted. Our results showed that, in addition to ST deviation, there is a temporal evolution in the QRS and T wave amplitudes, durations and areas during artery occlusion. Repolarization features showed faster and stronger changes than depolarization ones. A distinctive spatial lead profile was described in patients with occlusions in the left anterior descending artery and the right coronary artery. In conclusion, PCI-induced acute ischemia results in changes in the ECG waveforms, specially in the T wave, which vary as a function of the occlusion site.