Intracardiac electrocardiography from the coronary sinus as a unified method for monitoring the degree and topics of ischemia during endovascular coronary interventions

Intraoperative monitoring of ischemic dynamics during endovascular interventions on the coronary arteries is limited by the standard ECG technique and is an urgent problem for interventional surgeons. The aim of this work was to assess the ability to control ischemia using the unified method of intracardiac ECG from the coronary sinus and to analyze the correspondence of the electrode leads to the coronary basins. During endovascular surgery, an intracardiac electrode was installed in 72 patients with lesions of different coronary arteries. Using an electrophysiological study station, it was proved that the technique of electrocardiography from the coronary sinus allows us to determine the dynamics of the ST-segment during endovascular interventions in patients with coronary artery disease, as well as fairly accurately identify the localization of the ischemic region in the pool of a particular heart artery. It has been established that this method of intraoperative monitoring of myocardial ischemia exceeds the standard surface ECG in terms of informativeness and opens up additional possibilities for instrumental monitoring of myocardial state in invasive cardiology.