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Detection of acute ischemia from the EASI-derived 12-lead electrocardiogram and from the 12-lead electrocardiogram acquired in clinical practice

Sejersten, Maria; Wagner, Galen S.; Pahlm, Olle LU ; Warren, James W.; Feldman, Charles L. and Horacek, B. Milan (2007) In Journal of Electrocardiology 40(2). p.120-126
Abstract
ST-segment measurements in the standard 12-lead electrocardiogram (ECG) of patients with acute coronary syndromes are crucial for these patients' management. Our objective was to determine whether the 12-lead ECG derived from the 3-lead EASI system can attain a level of diagnostic performance similar to that of the Mason-Likar (ML) 12-lead ECG acquired in clinical practice (CP) by paramedics and emergency department technicians. Using 120-lead body surface potential maps recorded before and during balloon inflation angioplasty from 88 patients (divided into "responders" and "nonresponders"), and electrode placement data from 60 applications of precordial leads in CP, we generated for the "nonischemic" and "ischemic' states of each patient... (More)
ST-segment measurements in the standard 12-lead electrocardiogram (ECG) of patients with acute coronary syndromes are crucial for these patients' management. Our objective was to determine whether the 12-lead ECG derived from the 3-lead EASI system can attain a level of diagnostic performance similar to that of the Mason-Likar (ML) 12-lead ECG acquired in clinical practice (CP) by paramedics and emergency department technicians. Using 120-lead body surface potential maps recorded before and during balloon inflation angioplasty from 88 patients (divided into "responders" and "nonresponders"), and electrode placement data from 60 applications of precordial leads in CP, we generated for the "nonischemic" and "ischemic' states of each patient the following lead sets: the ML 12-lead ECG, the EASI-derived 12-lead ECG, and 60 sets of 12-lead CP ECGs. We extracted ST deviations at J + 60 milliseconds, summed them for all 12 leads of each lead set to obtain Sigma ST, and, by using the bootstrap method, determined the mean sensitivity and specificity for recognizing the "ischemic' state at various thresholds of Sigma ST. Results were displayed as receiver operating characteristics, and the area under these curves (AUC) +/- SE was used as the measure of diagnostic performance. AUC SE for all patients were ML ECG, 0.66 +/- 0.03; EASI ECG, 0.64 +/- 0.03; and CP ECG, 0.67 +/- 0.03. Corresponding results for responders only were 0.81 +/- 0.04 for ML ECG, 0.78 +/- 0.04 for EASI ECG, and 0.81 +/- 0.04 for CP ECG. The differences between the AUCs for the different lead sets were not significant (P >.05). Thus, the EASI-derived 12-lead ECG is as good for detecting acute ischemia as is the 12-lead ECG acquired in CP. (c) 2007 Elsevier Inc. All rights reserved. (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
Mason-Likar leads, electrocardiogram, FASI leads, acute ischemia
in
Journal of Electrocardiology
volume
40
issue
2
pages
120 - 126
publisher
Elsevier
external identifiers
  • wos:000245166900004
  • scopus:33847357356
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2006.08.099
language
English
LU publication?
yes
id
229e65b8-af5d-4d8e-844e-612c80f49deb (old id 670410)
date added to LUP
2007-12-18 14:38:42
date last changed
2017-08-27 04:02:30
@article{229e65b8-af5d-4d8e-844e-612c80f49deb,
  abstract     = {ST-segment measurements in the standard 12-lead electrocardiogram (ECG) of patients with acute coronary syndromes are crucial for these patients' management. Our objective was to determine whether the 12-lead ECG derived from the 3-lead EASI system can attain a level of diagnostic performance similar to that of the Mason-Likar (ML) 12-lead ECG acquired in clinical practice (CP) by paramedics and emergency department technicians. Using 120-lead body surface potential maps recorded before and during balloon inflation angioplasty from 88 patients (divided into "responders" and "nonresponders"), and electrode placement data from 60 applications of precordial leads in CP, we generated for the "nonischemic" and "ischemic' states of each patient the following lead sets: the ML 12-lead ECG, the EASI-derived 12-lead ECG, and 60 sets of 12-lead CP ECGs. We extracted ST deviations at J + 60 milliseconds, summed them for all 12 leads of each lead set to obtain Sigma ST, and, by using the bootstrap method, determined the mean sensitivity and specificity for recognizing the "ischemic' state at various thresholds of Sigma ST. Results were displayed as receiver operating characteristics, and the area under these curves (AUC) +/- SE was used as the measure of diagnostic performance. AUC SE for all patients were ML ECG, 0.66 +/- 0.03; EASI ECG, 0.64 +/- 0.03; and CP ECG, 0.67 +/- 0.03. Corresponding results for responders only were 0.81 +/- 0.04 for ML ECG, 0.78 +/- 0.04 for EASI ECG, and 0.81 +/- 0.04 for CP ECG. The differences between the AUCs for the different lead sets were not significant (P >.05). Thus, the EASI-derived 12-lead ECG is as good for detecting acute ischemia as is the 12-lead ECG acquired in CP. (c) 2007 Elsevier Inc. All rights reserved.},
  author       = {Sejersten, Maria and Wagner, Galen S. and Pahlm, Olle and Warren, James W. and Feldman, Charles L. and Horacek, B. Milan},
  issn         = {1532-8430},
  keyword      = {Mason-Likar leads,electrocardiogram,FASI leads,acute ischemia},
  language     = {eng},
  number       = {2},
  pages        = {120--126},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {Detection of acute ischemia from the EASI-derived 12-lead electrocardiogram and from the 12-lead electrocardiogram acquired in clinical practice},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2006.08.099},
  volume       = {40},
  year         = {2007},
}