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Document Details : Title: Evaluation of Electrocardiographic Algorithms in the Assessment of the Infarct-related Artery in Acute Myocardial Infarction Author(s): WITTERS, Peter Gerard Julia , COOLS, Frank Johan Journal: Acta Cardiologica Volume: 61 Issue: 4 Date: August 2006 Pages: 446-453 DOI: 10.2143/AC.61.4.2017307 Abstract : Objectives — In acute myocardial infarction,it is of great value to identify the infarct-related artery and the site of occlusion in a coronary artery (proximal versus distal).This study assessed the diagnostic value of two previously published electrocardiographic algorithms to identify the infarct-related artery and the site of occlusion in anterior and inferior acute myocardial infarction. Methods and results — We studied retrospectively a group of 88∞∞patients with a first myocardial infarction. We determined the infarct-related artery using the electrocardiographic algorithms on the electrocardiogram at the time of admission and compared these results with the angiographically determined infarct-related artery. The best electrocardiographic algorithm could determine the infarct-related artery in an inferior myocardial infarction as the left circumflex coronary artery and as the proximal and distal right coronary artery with a sensitivity of 63%, 67% and 80%, respectively, and a specificity of 100%, 82% and 69%, respectively. One algorithm was unable to diagnose a left circumflex coronary artery occlusion. In an anterior myocardial infarction the best electrocardiographic algorithm could determine the infarct-related artery as the proximal and distal left anterior descending coronary artery with a sensitivity of 85% and 80%, respectively, and with a specificity of 77% and 82%, respectively. Conclusion — In acute myocardial infarction the use of electrocardiographic algorithms is helpful to predict the site of occlusion and can play a crucial role in the care of patients. |
