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Abstract
This study aimed to evaluate the effect of thrombolytic therapy on Pmin , Pmax and PWD and to estimate if there is any special lead distribution of Pmin or Pmax. Also to evaluate the relation between the severity of STEMI and the extent of PWD. The study was carried out on 30 patients with ST segment elevation myocardial infarction. They were admitted to Critical Care Department in Alexandria Main University Hospital.
These patients received thrombolytic therapy (streptokinase) in addition to standard medical therapy.ECG done on admission and 1 hour after thrombolytic therapy then twice daily. Patients were divided after thrombolytic therapy into two groups according to the response of the patients. Group A: Patients with successful thrombolytic therapy and group B: Patients with failed thrombolytic therapy. P wave was observed in both groups.
Results:
• P wave dispersion (PWD) in patients with STEMI was higher than normal range.
• PWD on admission was positively related to age, ST deviation score , CK_MB ,troponine , left atrial size , ejection fraction and presence of heart failure and inversely related to betablocker use before admission and not related to the heart rate.
• No specific lead distribution of Pmin or Pmax before or after thrombolytic therapy.
• No significant difference between sites of infarction (anterior, inferior or anterior and inferior) as regard PWD.
• After thrombolytic therapy, PWD and Pmax were higher in group B than in group A.
• By further subdividing both groups according to the site of infarction we found that on difference as regard PWD.