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Sgarbossa Criteria are Highly Specific for Acute Myocardial Infarction with Pacemakers.
MedLine Citation:
PMID:  21079708     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: In 1996 Sgarbossa reviewed 17 ventricular-paced electrocardiograms (ECGs) in acute myocardial infarction (AMI) for signs of ischemia. Several characteristics of the paced ECG were predictive of AMI. We sought to evaluate the criteria in ventricular-paced ECGs in an emergency department (ED) cohort.
METHODS: Ventricular-paced ECGs in patients with elevated cardiac markers within 12 hours of the ED ECG and a diagnosis of AMI were identified retrospectively (n=57) and compared with a control group of patients with ventricular-paced ECGs and negative cardiac markers (n=99). A blinded board certified cardiologist reviewed all ECGs for Sgarbossa criteria. This study was approved by the institutional review board.
RESULTS: Application of Sgarbossa's criteria to the paced ECGs revealed the following: The sensitivity of "ST-segment elevation of 1 mm concordant with the QRS complex" was unable to be calculated as no ECG fit this criterion;For "ST-segment depression of 1 mm in lead V1, V2, or V3," the sensitivity was 19% (95% CI 11-31%), specificity 81% (95% CI 72-87%), with a likelihood ratio of 1.06 (0.63-1.64);For "ST-segment elevation >5mm discordant with the QRS complex," the sensitivity was 10% (95% CI 5-21%), specificity 99% (95% CI 93-99%), with a likelihood ratio of 5.2 (1.3 - 21).
CONCLUSION: In our review of ventricular-paced ECGs, the most clinically useful Sgarbossa criterion in identifying AMI was ST-segment elevation >5mm discordant with the QRS complex. This characteristic may prove helpful in identifying patients who may ultimately benefit from early aggressive AMI treatment strategies.
Kevin R Maloy; Rahul Bhat; Jonathan Davis; Kevin Reed; Richard Morrissey
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The western journal of emergency medicine     Volume:  11     ISSN:  1936-9018     ISO Abbreviation:  West J Emerg Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101476450     Medline TA:  West J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  354-7     Citation Subset:  -    
Georgetown University, Department of Emergency Medicine, Washington, DC.
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