Document Detail

Use of the 24-lead "standard" electrocardiogram to identify the site of acute coronary occlusion. A review paper.
MedLine Citation:
PMID:  18433615     Owner:  NLM     Status:  MEDLINE    
This review presents the added value for diagnosis of acute ischemia/infarction of considering ST elevation in the 12 inverted leads (-I, -II, -II, -aVR, etc) of the standard electrocardiogram in addition to ST elevation in 12 positive leads. A small number of studies have been published showing substantial increases in sensitivity at the "cost of" slight decreases in specificity. One recent study indicated that only 7 of the inverted leads should be considered, yielding a "19-lead electrocardiogram" encompassing the following leads (presented here in the logical sequences): -III, aVL, I, -aVR, II, aVF, III, -aVL, -I, aVR; and V1, V2, V3, V4, V5, V6, -V1, -V2, -V3. Studies have to be performed to establish the thresholds that should be applied to these leads for achievement of sensitivity/specificity.
Galen S Wagner; Ulrika Pahlm-Webb; Olle Pahlm
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  41     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-04-24     Completed Date:  2008-05-28     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  238-44     Citation Subset:  IM    
Duke University Medical Center, Durham, NC 27705, USA.
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MeSH Terms
Acute Disease
Body Surface Potential Mapping / instrumentation*,  standards*
Coronary Stenosis / diagnosis*
Diagnosis, Computer-Assisted / methods,  standards*
Electrocardiography / instrumentation*,  standards*
Reference Standards

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