학술논문

J wave dynamicity during coronary angiography and intracoronary acetylcholine administration.
Document Type
Article
Source
Pacing & Clinical Electrophysiology. Aug2023, Vol. 46 Issue 8, p868-874. 7p.
Subject
*CORONARY arterial radiography
*CORONARY vasospasm
*MYOCARDIAL ischemia
*CORONARY angiography
*ACETYLCHOLINE
*COMPARATIVE studies
*CORONARY artery disease
*ARRHYTHMIA
*DISEASE complications
Language
ISSN
0147-8389
Abstract
Background: J‐waves may be observed during coronary angiography (CAG) or intracoronary acetylcholine (ACh) administration, but their significance is unknown. Methods: Forty‐nine patients, 59.1 ± 11.5 years old and 59% male, were studied on suspicion of vasospastic angina, and J wave dynamicity was compared between CAG and Ach administration. Results: Diagnostic (≥0.1 mV) or nondiagnostic (<0.1 mV) J waves in 9 and 3 patients, respectively, were augmented, and J waves were newly observed in 2 patients during CAG and Ach administration. Similar changes in the J‐wave amplitude were observed: from 0.10 ± 0.09 mV to 0.20 ± 0.15 mV (p <.002) and from 0.10 ± 0.10 mV to 0.20 ± 0.16 mV (p <.001) during CAG and Ach administration, respectively. J waves were located in the inferior leads and changed only during the right coronary interventions. In the remaining 35 patients, J waves were absent before and during the coronary interventions. Augmentation of J waves was found when the RR interval was shortened in some patients. Injection of anoxic media into the coronary artery might induce a conduction delay from myocardial ischemia that manifests as augmentation or new occurrence of J waves. Conclusions: Both CAG and intracoronary Ach administration affected J waves similarly in the same individuals. A myocardial ischemia‐induced conduction delay may be responsible for the changes in J waves, but further studies are needed. [ABSTRACT FROM AUTHOR]