Document Detail


New criteria based on ST changes in 12-lead surface ECG to detect proximal versus distal right coronary artery occlusion in a case of acute inferoposterior myocardial infarction.
MedLine Citation:
PMID:  15485518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The outcome of patients with inferoposterior myocardial infarction (MI) due to occlusion of right coronary artery (RCA) depends mainly on the location of occlusion (distal vs. proximal). The aim of this study was to evaluate the value of new ECG criteria: the sum of ST depression in I and VL leads and ST changes in V1 lead to predict the location of RCA occlusion in the case of an inferoposterior MI. METHODS: The ECG and angiographical findings of 50 patients with acute inferoposterior MI due to RCA occlusion were analyzed. The value of new criteria was studied alone and in combination to predict proximal versus distal RCA occlusion and compared with previously described criterion based only on ST changes in VL. RESULTS: Isoelectric or elevated ST in V1 allowed predicting proximal RCA occlusion with 70% sensitivity and 87% specificity with high positive and negative predictive value (87% and 71%, respectively). The new criterion of the sum of ST depression in I and VL >or= 5.5 mm compared to the criterion based only on ST depression in VL was also more specific (91% vs. 72%) for proximal RCA occlusion with better positive and negative predictive values. CONCLUSIONS: The new criterion based on the ST changes in V1 lead is highly accurate in detecting the location of occlusion in the RCA compared to the criteria based only on ST changes in lateral leads. The use of this criterion might increase the accuracy of ECG-based identification of myocardial involvement in acute inferoposterior MI.
Authors:
Miquel Fiol; Andrés Carrillo; Iwona Cygankiewicz; José Ayestarán; Onofre Caldés; Vicente Peral; Armando Bethencourt; Wojciech Zareba; Antoni Bayés de Luna
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  9     ISSN:  1082-720X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-15     Completed Date:  2005-02-17     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  383-8     Citation Subset:  IM    
Affiliation:
Hospital Son Dureta, Palma de Mallorca, Spain. mfiol@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Coronary Stenosis / complications*,  diagnosis*
Coronary Vessels*
Electrocardiography*
Female
Humans
Male
Middle Aged
Myocardial Infarction / etiology*
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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