Maximal increase in sensitivity with minimal loss of specificity for diagnosis of acute coronary occlusion achieved by sequentially adding leads from the 24-lead electrocardiogram to the orderly sequenced 12-lead electrocardiogram

Journal of Electrocardiology

Volumn 40, Issue 6, 2007, Pages 463-469

  Perron, Annick ^a   Lim, Tobin ^b   Pahlm Webb, Ulrika ^b   Wagner, Galen S ^b   Pahlm, Olle ^a  

^a LUND UNIVERSITY HOSPITAL   (Sweden)

^b DUKE UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

12 Lead ECG; Acute coronary syndromes; Acute myocardial infarction; PTCA; Sensitivity; Specificity

Indexed keywords

ADULT; AGED; ARTICLE; BALLOON OCCLUSION; CORONARY ARTERY CIRCUMFLEX BRANCH; CORONARY ARTERY THROMBOSIS; ELECTROCARDIOGRAM; EPICARDIUM; FEMALE; HEART INFARCTION; HEART MUSCLE ISCHEMIA; HUMAN; LEFT ANTERIOR DESCENDING CORONARY ARTERY; MAJOR CLINICAL STUDY; MALE; PERCUTANEOUS CORONARY INTERVENTION; PRIORITY JOURNAL; RIGHT CORONARY ARTERY; SENSITIVITY AND SPECIFICITY; ST ELEVATION MYOCARDIAL INFARCTION; TRANSLUMINAL CORONARY ANGIOPLASTY; UNITED KINGDOM;

ADULT; AGED; AGED, 80 AND OVER; CORONARY OCCLUSION; ELECTROCARDIOGRAPHY; FEMALE; HUMANS; MALE; MIDDLE AGED; MYOCARDIAL ISCHEMIA; REPRODUCIBILITY OF RESULTS; SENSITIVITY AND SPECIFICITY;

EID: 35748932025     PISSN: 00220736     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jelectrocard.2007.07.002     Document Type: Article

References (18)

1. Brush Jr. J.E., Brand D.A., Acampora D., Chalmer B., and Wackers F.J. Use of the initial electrocardiogram to predict in-hospital complications of acute myocardial infarction. N Engl J Med 312 (1985) 1137
2. Goldman L., Weinberg M., Weisberg M., et al. A computer-derived protocol to aid in the diagnosis of emergency room patients with acute chest pain. N Engl J Med 307 (1982) 588
3. Pahlm-Webb U., Pahlm O., Sadanandan S., Selvester R.H., and Wagner G.S. A new method for using the direction of ST-segment deviation to localize the site of acute coronary occlusion: the 24-view standard electrocardiogram. Am J Med 113 (2002) 75
4. Novak P.G., Davies C., and Gin K.G. Survey of British Columbia cardiologists' and emergency physicians' practice of using nonstandard ECG leads (V4R to V6R and V7 to V9) in the diagnosis and treatment of acute myocardial infarction. Can J Cardiol 15 (1999) 967
5. Horacek B.M., and Wagner G.S. Electrocardiographic ST-segment changes during acute myocardial ischemia. Card Electrophysiol Rev 6 (2002) 196
6. Pahlm U.S., Pahlm O., and Wagner G.S. The standard 11-lead ECG. Neglect of lead aVR in the classical limb lead display. J Electrocardiol 29 Suppl (1996) 270
7. Sgarbossa E.B., Barold S.S., Pinski S.L., Wagner G.S., and Pahlm O. Twelve-lead electrocardiogram: the advantages of an orderly frontal lead display including lead -aVR. J Electrocardiol 37 (2004) 141
8. Alpert J.S., Thygesen K., Antman E., and Bassand J.P. Myocardial infarction redefined-a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 36 (2000) 959
9. Sadanandan S., Hochman J.S., Kolodziej A., et al. Clinical and angiographic characteristics of patients with combined anterior and inferior ST-segment elevation on the initial electrocardiogram during acute myocardial infarction. Am J Heart 146 (2003) 653
10. Anderson S.T., Pahlm O., Selvester R.H., et al. Panoramic display of the orderly sequenced 12-lead ECG. J Electrocardiol 27 (1994) 347
11. Macfarlane P. Appendix 1: normal limits. In: Macfarlane P., and Lawrie T. (Eds). Comprehensive electrocardiology. 1st ed. (1989), Pergamon Press, New York 1442
12. Aldrich H.R., Hindman N.B., Hinohara T., et al. Identification of the optimal electrocardiographic leads for detecting acute epicardial injury in acute myocardial infarction. Am J Cardiol 59 (1987) 20
13. Wellens H.J.J., Gorgels A.P.M., and Doevendans P.A. The ECG in acute myocardial infarction and unstable angina (1984), Kluwer, Boston
14. Martin T.N., Groenning B.A., Murray H.M., et al. ST-segment deviation analysis of the admission 12-lead electrocardiogram as an aid to early diagnosis of acute myocardial infarction with a cardiac magnetic resonance imaging gold standard. J Am Coll Cardiol 50 11 (2007) 1021
15. Menown I.B., Mackenzie G., and Adgey A.A. Optimizing the initial 12-lead electrocardiographic diagnosis of acute myocardial infarction. Eur Heart J 21 (2000) 275
16. Zalenski R.J., Cooke D., Rydman R., Sloan E.P., and Murphy D.G. Assessing the diagnostic value of an ECG containing leads V4R, V8 and V9: the 15-lead ECG. Ann Emerg Med 22 (1993) 786
17. Shah A., Wagner G.S., Green C.L., et al. Electrocardiographic differentiation of the ST-segment depression of acute myocardial injury due to the left circumflex artery occlusion from that of myocardial ischemia of nonocclusive etiologies. Am J Cardiol 80 (1997) 512
18. White T. The sequence of the extremity leads in ECG (in Swedish). Lakartidningen 134 (1971) 1014