The Effect of Coronary Stenting on Ventricular Activation Time in Coronary Artery Disease

ABSTRACT

BACKGROUND AND OBJECTIVES: The ventricular activation time (VAT) is increased in both ventricular hypertrophy and bundle branch block. It is also known that the VAT is increased in myocardial ischemia due to the development of depolarization abnormality. However, little is known about the changes in the VAT on body surface electrocardiography following coronary stenting in patients with ischemic heart disease. The purpose of this study was to evaluate the clinical significance of VAT following coronary stenting by assessing the changes in the VAT during the 6 months following coronary stenting in patients with ischemic heart disease. SUBJECTS AND METHODS: The VAT was measured in 92 patients who had underdone coronary stenting due to of significant coronary artery stenosis on coronary angiography. The electrocardiography was recorded with a high paper speed at pre-stenting, immediate after and at 1 and 6 months after coronary stenting. RESULTS: The VAT was significantly decreased during the 6 month follow-up following coronary stenting (pre-stenting ; 45.9 +/-5.9 msec, immediate after stenting ; 38.5+/-2.7 msec, after 1 month ; 38.8+/-2.8 msec and after 6 months ; 38.8+/-2.5 msec, p<0.05). The VAT dispersion was significantly decreased during the 6 month follow-up following coronary stenting in the patients with one vessel disease (p<0.05), but not with two vessels disease. CONCLUSION: Coronary stenting significantly decreased the VAT during the 6 month follow-up. We would conclude that coronary stenting relieves depolarization abnormalities caused by myocardial ischemia, and improves the intraventricular conduction velocity. However, further studies are needed to assess the usefulness of VAT in evaluating myocardial ischemia.