Intracoronary ECG May Reveal Dynamic Changes in Tissue-Level Reperfusion During Primary PCI

Aslanger E. K., Akaslan D., UYSALER E., Türer Cabbar A., Taşdelen N., Özkök S., ...More

JACC: Case Reports, vol.31, no.18, 2026 (Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 31 Issue: 18
  • Publication Date: 2026
  • Doi Number: 10.1016/j.jaccas.2026.107725
  • Journal Name: JACC: Case Reports
  • Journal Indexes: Scopus, EMBASE, Directory of Open Access Journals
  • Keywords: cardiac magnetic resonance, electrocardiogram, myocardial infarction
  • Marmara University Affiliated: Yes

Abstract

Background: Intracoronary electrocardiogram (IC-ECG) shows sustained ST-segment resolution in some patients but re-emergence of elevation after stent deployment in others. These findings correspond to differences in infarct characteristics on cardiac magnetic resonance. Case Summary: The IC-ECG observations during percutaneous coronary intervention (PCI) from 15 patients with anterior myocardial infarction, obtained by connecting the guidewire to the ECG system, were compared with images from cardiac magnetic resonance. Take-Home Messages: IC-ECG recordings obtained during sequential steps of primary PCI may demonstrate dynamic ST-segment changes reflecting possible impaired microvascular reperfusion. Further studies are needed to evaluate IC-ECG as a real-time marker of myocardial reperfusion during PCI.