The dependence of the STEMI classification on the position of ST-deviation measurement instant relative to the J point

Introduction. The electrocardiogram (ECG) is an important diagnostic tool in acute coronary syndrome (ACS). STEMI (ST Elevation Myocardial Infarction) is formally diagnosed by ST-deviations measured at the J point. However, due to uncertainty about the position and amplitude of the J point, ST deviations are often measured at a fixed-time interval after the J point. The impact of the position of the ST-deviation measurement on STEMI classification is not known and is the subject of the current study.

[1]  E. W. Hancock,et al.  Recommendations for the standardization and interpretation of the electrocardiogram. Part I: The electrocardiogram and its technology. A scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Car , 2007, Heart rhythm.

[2]  E. W. Hancock,et al.  Recommendations for the standardization and interpretation of the electrocardiogram: part II: Electrocardiography diagnostic statement list: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College , 2007, Circulation.

[3]  O. Pahlm,et al.  Comparison of model-based and expert-rule based electrocardiographic identification of the culprit artery in patients with acute coronary syndrome. , 2015, Journal of electrocardiology.

[4]  H. Tan,et al.  Electrocardiographic patterns in posterior chest leads (V7, V8, V9) in normal subjects. , 2000, The American journal of cardiology.

[5]  E. W. Hancock,et al.  AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part VI: acute ischemia/infarction: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Card , 2009, Journal of the American College of Cardiology.

[6]  E. W. Hancock,et al.  AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American , 2009, Journal of the American College of Cardiology.

[7]  A. Gorgels,et al.  Will future troponin measurement overrule the ECG as the primary diagnostic tool in patients with acute coronary syndrome? , 2013, Journal of electrocardiology.

[8]  M.J. Schalij,et al.  LEADS: an interactive research oriented ECG/VCG analysis system , 2005, Computers in Cardiology, 2005.

[9]  José García,et al.  Identification of the Occluded Artery in Patients with Myocardial Ischemia Induced by Prolonged Percutaneous Transluminal Coronary Angioplasty Using Traditional vs Transformed ECG-Based Indexes , 1999, Comput. Biomed. Res..