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FFR vs icECG in Coronary Bifurcations


FFR vs icECG in Coronary Bifurcations

European Bifurcation Club 2016 – EBC 2016 – Rotterdam, The Netherlands

Assessment of bifurcation lesions

FFR vs icECG in Coronary Bifurcations 

Author: Dobrin Vassilev MD, PhD Assoc. Prof. in Cardiology, Head Cardiology Clinic, “Alexandrovska” University Hospital, Medical University, Sofia, Bulgaria



  • to verify in head-to-head comparison ability to detect periprocedural ischemia of FFR vs. icECG
  • to verify ability of icECG to identify ischemia generating (hemodynamically significant?) SB stenosis at the ostium of side branches


  • Intracoronary ECG (based on ST-segment elevation) could predict a “significant” FFR in SB region after main vessel stenting with high overall accuracy of 88%
  • In case of negative icECG signs of ischemia (no STS elevation, no change in QRS amplitude (R>S) and width (QRS>110ms)) FFR is not necessary, no matter how large is SB and how severe the ostial stenosis in SB looks like
  • A COSIBRIA II randomized study is planned to assess in long-term effect of SB pharmaco-mechanical intervention on patient oriented events in icECG ischemic SBs


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