Heart-attack patients whose electrocardiogram (EKG) patterns are continuously monitored in the hospital are likely to have less heart damage and improved outcomes, according to UCSF researchers who reported a new monitoring technique yesterday at the American Heart Association's 70th Scientific Sessions in Orlando, Fla.

Every individual who suffers a heart attack has an EKG pattern that is as unique as a fingerprint, according to Barbara Drew, RN, PhD, professor in the UCSF School of Nursing. Normally, this EKG information--which is a record of electrical activity from 12 different viewpoints and is known as the 12-lead EKG pattern--is documented once when an individual arrives at the hospital but is not continuously monitored thereafter. Drew and her colleagues at UCSF found that by continuously monitoring a patient's 12-lead EKG pattern during the hospital stay, problems with inadequate blood flow to the heart can be detected better than by using the current routine monitoring methods.

"This type of non-invasive monitoring is going to revolutionize the way we monitor patients in a hospital setting," she said. Problems with inadequate blood flow to the heart go undetected 80% of the time because the patient does not experience chest pain or other warning symptoms during these inadequate blood flow events, Drew reported.

Of the 422 patients in Drew's study, 118 patients had a total of 463 inadequate blood flow events. The 12-lead EKG monitoring method detected 100 percent of these events, but the routine way of monitoring detected only 33 percent. Drew said there has been increasing interest in the development of non-invasive monitoring of patients.

"If we can get just as good information about what is wrong with a patient's heart without using drugs or needles, that is the preferred way to go," Drew said. "This type of monitoring is less costly and has no complications for patients."

Drew's presentation, "Is 12-Lead ST Segment Monitoring Necessary to Detect Ongoing Ischemia in Patients with Unstable Coronary Syndromes?" was selected as one of three finalists in the Heart Association's new investigator awards competition earlier in May. The presentation will be included in a final competition during the conference. The first-place winner, which carries a cash award, will be announced tomorrow.

By Dale Martin

1st appeared 11/10/97

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