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Detection of acute myocardial infarction using the 12-lead ECG plus inverted leads versus the 16-lead ECG (with additional posterior and right-sided chest electrodes).

Trägårdh, Elin LU ; Claesson, Mikaela; Wagner, Galen S; Zhou, Sophia and Pahlm, Olle LU (2007) In Clinical Physiology and Functional Imaging 27(6). p.368-374
Abstract
Background: The electrocardiographic (ECG) diagnosis of acute myocardial infarction (MI) should be improved. This might be done either by regarding all 24 aspects (both positive and negative leads), or a subset hereof (e.g. 19-lead ECG), of the conventional 12-lead ECG or by using additional electrodes. The purpose of this study was to investigate the accuracy of the different ECG methods in diagnosing acute ST-elevation MI. Methods: The study population consisted of 479 patients admitted to Lund University Hospital with acute chest pain. One conventional ECG plus leads V4R, V5R, V8 and V9 were recorded for each patient within 24 h of admittance. Biochemical markers were used as the 'gold standard' for diagnosis of MI. We measured... (More)
Background: The electrocardiographic (ECG) diagnosis of acute myocardial infarction (MI) should be improved. This might be done either by regarding all 24 aspects (both positive and negative leads), or a subset hereof (e.g. 19-lead ECG), of the conventional 12-lead ECG or by using additional electrodes. The purpose of this study was to investigate the accuracy of the different ECG methods in diagnosing acute ST-elevation MI. Methods: The study population consisted of 479 patients admitted to Lund University Hospital with acute chest pain. One conventional ECG plus leads V4R, V5R, V8 and V9 were recorded for each patient within 24 h of admittance. Biochemical markers were used as the 'gold standard' for diagnosis of MI. We measured ST-segment elevations in the 12-, 16- and 24-lead postadmission ECGs as well as in the 12-, 19- and 24-lead admission ECGs. Results: The sensitivity for detecting acute MI was 28% for the postadmission 12-lead ECG, 33% for the 16-lead ECG and 37% for the 24-lead ECG. The specificities were 97%, 93% and 95%, respectively. For admission ECGs, the sensitivity was 33% for the 12-lead ECG, 45% for the 19-lead ECG and 49% for the 24-lead ECG, with specificities of 97%, 96% and 94%, respectively. Conclusion: The sensitivity for detecting acute MI was higher for the 16-, 19- and 24-lead ECGs than for the conventional 12-lead ECGs. Their specificity, however, was slightly lower. If increased sensitivity for detecting MI is desired, the 24-lead or 19-lead should be used as no additional electrodes are required. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
24-lead ECG, acute, coronary syndrome, myocardial infarction, 19-lead ECG, 16-lead ECG
in
Clinical Physiology and Functional Imaging
volume
27
issue
6
pages
368 - 374
publisher
Wiley Online Library
external identifiers
  • wos:000250261600005
  • scopus:35349024289
ISSN
1475-0961
DOI
10.1111/j.1475-097X.2007.00761.x
language
English
LU publication?
yes
id
42120d6b-266a-471b-9b12-ab86fa024715 (old id 608447)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17944659&dopt=Abstract
date added to LUP
2008-01-03 11:02:48
date last changed
2017-10-22 03:36:54
@article{42120d6b-266a-471b-9b12-ab86fa024715,
  abstract     = {Background: The electrocardiographic (ECG) diagnosis of acute myocardial infarction (MI) should be improved. This might be done either by regarding all 24 aspects (both positive and negative leads), or a subset hereof (e.g. 19-lead ECG), of the conventional 12-lead ECG or by using additional electrodes. The purpose of this study was to investigate the accuracy of the different ECG methods in diagnosing acute ST-elevation MI. Methods: The study population consisted of 479 patients admitted to Lund University Hospital with acute chest pain. One conventional ECG plus leads V4R, V5R, V8 and V9 were recorded for each patient within 24 h of admittance. Biochemical markers were used as the 'gold standard' for diagnosis of MI. We measured ST-segment elevations in the 12-, 16- and 24-lead postadmission ECGs as well as in the 12-, 19- and 24-lead admission ECGs. Results: The sensitivity for detecting acute MI was 28% for the postadmission 12-lead ECG, 33% for the 16-lead ECG and 37% for the 24-lead ECG. The specificities were 97%, 93% and 95%, respectively. For admission ECGs, the sensitivity was 33% for the 12-lead ECG, 45% for the 19-lead ECG and 49% for the 24-lead ECG, with specificities of 97%, 96% and 94%, respectively. Conclusion: The sensitivity for detecting acute MI was higher for the 16-, 19- and 24-lead ECGs than for the conventional 12-lead ECGs. Their specificity, however, was slightly lower. If increased sensitivity for detecting MI is desired, the 24-lead or 19-lead should be used as no additional electrodes are required.},
  author       = {Trägårdh, Elin and Claesson, Mikaela and Wagner, Galen S and Zhou, Sophia and Pahlm, Olle},
  issn         = {1475-0961},
  keyword      = {24-lead ECG,acute,coronary syndrome,myocardial infarction,19-lead ECG,16-lead ECG},
  language     = {eng},
  number       = {6},
  pages        = {368--374},
  publisher    = {Wiley Online Library},
  series       = {Clinical Physiology and Functional Imaging},
  title        = {Detection of acute myocardial infarction using the 12-lead ECG plus inverted leads versus the 16-lead ECG (with additional posterior and right-sided chest electrodes).},
  url          = {http://dx.doi.org/10.1111/j.1475-097X.2007.00761.x},
  volume       = {27},
  year         = {2007},
}