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  • 1
    Electronic Resource
    Electronic Resource
    The Diagnostic Value of 12-Lead Electrocardiogram in Predicting Infarct-Related Artery and Right Ventricular Involvement in Acute Inferior Myocardial Infarction (2001)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of noninvasive electrocardiology 6 (2001), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The aim of the present study was to investigate the predictive value of presentation and 24-hour electrocardiograms in defining the infarct-related artery (IRA), its lesion segment, and the right ventricular involvement in acute inferior myocardial infarction (Ml).Methods: One hundred forty-nine patients with acute inferior MI were included. Infarct-related artery, its lesion segment, and the validity of new ECG criteria for the diagnosis of right ventricular Ml (RVMI) were investigated by means of criteria obtained from admission and 24-hour ECGs.Results: The presence of ST-segment elevation in lead III 〉 lead II criterion (Criterion 1) and ST-segment depression in lead I 〉 lead aVL criterion (Criterion 2) from admission ECG defined the right coronary artery (RCA) as IRA with a sensitivity of 64% and a specificity of 100%. These two criteria also defined the proximal or mid lesions in RCA as culprit lesions (sensitivity of 99%, specificity of 96%). Absence of these two criteria indicated Cx as IRA with a sensitivity of 50% and a specificity of 97%. The depth of Q wave in lead III 〉 lead II criterion (Criterion 3) had no value for discrimination of IRA, but the width of Q wave in lead III 〉 lead II criterion (Criterion 4) supported the RCA to be IRA with a sensitivity of 60% and a specificity of 61% (Criteria 3 and 4 were obtained from 24-hour ECGs). The finding of Criterion 1 plus Criterion 5 (ST elevation in V1 but no ST elevation in V2) on admission ECG had a sensitivity of 63% and a specificity of 99% in the diagnosis of RVMI.Conclusion: We concluded that 12-lead ECG is a cheap, easy, and readily obtainable diagnostic approach in discrimination of IRA and its culprit lesion segment. However, despite high specificity, due to moderate degree sensitivity, its value for the diagnosis of RVMI is questionable. A.N.E. 2001; 6(3):229–235
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.2001.tb00113.x
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  • 2
    Electronic Resource
    Electronic Resource
    Assessment of Heart Rate Turbulence in the Acute Phase of Myocardial Infarction for Long-Term Prognosis (2003)
    350 Main Street , Malden , MA 02148-5018 , USA . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: SADE, E., et al.: Assessment of Heart Rate Turbulence in the Acute Phase of Myocardial Infarction for Long-Term Prognosis. This study is designed to assess the value of heart rate turbulence (HRT) in the acute phase of MI for prediction of long-term mortality risk. The study included 128 consecutive acute MI patients with 24-hour Holter recordings to evaluate HRT (turbulence onset and slope), SDNN, mean RR interval, and ventricular premature beat frequency. LVEF was evaluated by two-dimensional echocardiography. Data from 117 patients (mean age 58 ± 11 years) were available for further analysis. Twelve patients died during follow-up (mean 312 ± 78 days). Although SDNN 〈 70 ms was the most powerful predictor of mortality among all presumed risk factors (hazard ratio 20 [95% CI 2.6–158]; P = 0.004) in univariate Cox regression analysis, in multivariate analysis LVEF ≤ 0.40 and turbulence slope ≤2.5 ms/RR interval were the only independent predictors of mortality (hazard ratio 6.9 [95% CI 1.8–26]; P = 0.006, hazard ratio 7.3 [95% CI 1.4–37]; P = 0.016, respectively). Addition of HRT parameters for LVEF increased remarkably the positive predictive value (60%) without any decrease in the negative predictive value (92%). Blunted HRT reaction within the first 24 hours of acute MI is an independent predictor of long-term mortality. Furthermore, its predictive power is comparable and also additive to that of LVEF. (PACE 2003; 26[Pt. I]:544–550)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.00092.x
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  • 3
    Electronic Resource
    Electronic Resource
    P Wave Dispersion on 12-Lead Electrocardiography in Patients with Paroxysmal Atrial Fibrillation (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 23 (2000), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The prolongation of intraatrial and interatrial conduction time and the inhomogeneous propagation of sinus impulses have been shown in patients with atrial fibrillation. Recently P wave dispersion (PWD), which is believed to reflect inhomogeneous atrial conduction, has been proposed as being useful for the prediction of paroxysmal atrial fibrillation (PAF). Ninety consecutive patients (46 men, 44 women; aged 55 ± 13 years) with a history of idiopathic PAF and 70 healthy subjects (42 men, 28 women; mean age, 53 ± 14 years) were studied. The P wave duration was calculated in all 12 leads of the surface ECC. The difference between the maximum and minimum P wave duration was calculated and this difference was defined as P wave dispersion (PWD = Pmax - Pmin). All patients and controls were also evaluated by echocardiography to measure the left atrial diameter and left ventricular ejection fraction (LVEF). There was no difference between patients and controls in gender (P = 0.26), age (P = 0.12), LVEF (66 ± 4% vs 67 ± 5%, P = 0.8) and left atrial diameter (36 ± 4 mm vs 34 ± 6 mm, P = 0.13). P maximum duration was found to be significantly higher in patients with a history of PAF (116 ± 17 ms) than controls (101 ±11 ms. P 〈 0.001). P wave dispersion was also significantly higher in patients than in controls (44 ± 15 ms vs 27 ± 10 ms, P 〈 0.001). There was a weak correlation between age and P wave dispersion (r = 0.27, P 〈 0.001). A P maximum value of 106 ms separated patients with PAF from control subjects with a sensitivity of 83%, a specificity of 72%, and a positive predictive accuracy of 79%. A P wave dispersion value of 36 ms separated patients from control subjects with a sensitivity of 77%, a specificity of 82%, and a positive predictive accuracy of 85%. In conclusion, P maximum duration and P wave dispersion calculated on a standard surface ECG are simple ECG markers that could be used to identify the patients with idiopathic paroxysmal atrial fibrillation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2000.tb00910.x
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