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Journal of The Korean Society of Emergency Medicine 2004;15(3): 184-192. |
Myocardial Infarction: Comparison of 12-Lead Electrocardiographic Criteria with 80-Lead Body Surface Mapping |
Won Young Kim, Won Kim, Bum Jin Oh, Se Hyun Oh, Kyoung Soo Lim |
1Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, seoul, Korea. wkim@amc.seoul.kr 2Gang Nung Asan Hospital, Gangnung, Korea. |
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ABSTRACT |
PURPOSE: Right ventricular (RV) infarction is associated with increased morbidity and mortality in patients with acute inferior wall myocardial infarction (MI). A 12-lead electrocardiogram (ECG) has a poor tendency to identify RV involvement. Our objective was to evaluate the diagnostic accuracy of 80-lead body surface mapping (BSM) for RV infarction and to compare diagnostic accuracy of 12-lead ECG criteria and 80-lead BSM for RV infarction in patients with acute inferior wall MI.
METHODS: Between September 2002 and January 2003, 96 patients visited to our emergency center with AMI. All standard initial 12-lead ECG and 80-lead BSM were examined and compared with angiographic and echocardiographic findings.
RESULTS: Thirty-one patients were confirmed as inferior wall MI. With the use of exclusion criteria, sixteen patients included in this study. RV infarction accompanied in 5 patients of these 16 patients. BSM showed a high sensitivity (60%), specificity (82%), high positive and negative predictive values (60%, and 82%, respectively), and high diagnostic accuracy (75%) in diagnosing RV infarction in patients with acute inferior wall MI. BSM showed increase in the sensitivity for RV infarction from 40% to 60% when compared with the 12-lead ECG.
CONCLUSION: The 80-lead BSM is a more useful test in diagnosing RV infarction in patients with acute inferior wall |
Key words:
Myocardial infarction, Right ventricle, Body surface mapping |
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