1. Incidence and Implications of J waves Observed During Coronary Angiography
- Author
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Akinori Sato, Koichi Fuse, Yoshiyasu Aizawa, Masaaki Okabe, Yoshifusa Aizawa, Yuta Sakaguchi, and Takao Sato
- Subjects
Male ,medicine.medical_specialty ,Myocardial Infarction ,Myocardial Ischemia ,Contrast Media ,Coronary Angiography ,Angina Pectoris ,Angina ,Electrocardiography ,QRS complex ,Left coronary artery ,Cardiac Conduction System Disease ,Internal medicine ,medicine.artery ,medicine ,Humans ,Myocardial infarction ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Incidence ,Middle Aged ,medicine.disease ,Coronary arteries ,medicine.anatomical_structure ,Ventricle ,Right coronary artery ,Angiography ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
J waves may be observed during coronary angiography (CAG), but they have not been fully studied. We investigated the characteristics of J waves in 100 consecutive patients during CAG. The patients and their family members had no history of cardiac arrest. Approximately 60% of patients had ischemic heart disease, previous myocardial infarction, or angina pectoris, but at the time of this study, the right coronary artery was shown to be normal or patent after stenting. Electrocardiogram was serially recorded to monitor J waves and alteration of the QRS complex during CAG. In 12 patients (12%), J waves (0.249 ± 0.074 mV) newly appeared during right CAG, and in another 13 patients (13%), preexisting J waves increased from 0.155 ± 0.060 mV to 0.233 ± 0.133 mV during CAG. Left CAG induced no J waves or augmentation of J waves. Distinct alterations were observed in the QRS complex during CAG of both coronary arteries. Mechanistically, myocardial ischemia induced by contrast medium was considered to result in a local conduction delay, and when it occurred in the inferior wall, the site of the late activation of the ventricle, the conduction delay was manifested as J waves. In conclusion, J waves were confirmed to emerge or increase during angiography of the right but not the left coronary artery. Myocardial ischemia induced by contrast medium caused a local conduction delay that was manifested as J waves in the inferior wall, the site of the late activation of the ventricle.
- Published
- 2022