Improved detection of acute myocardial infarction using a diagnostic algorithm based on calculated epicardial potentials

C Owens, C Navarro, A McClelland, J Riddell, OJ Escalona, JMCC Anderson, JAA Adgey

Research output: Contribution to journalArticle

Abstract

Background: New methods for detecting myocardial infarction in patients with suspected acute coronary syndromes are needed particularly in an era where the majority of patients with myocardial infarction present with non-diagnostic 12-lead electrocardiograms (ECG). We compared a novel epicardial diagnostic algorithm using epicardial potentials from the 80-lead body surface map with other electrocardiographic techniques in detection of myocardial infarction. Methods: Between February 1999 and February 200 1, consecutive patients (n = 427) with ischemic type chest pain had an initial 12-lead ECG and body surface map recorded. Detecting myocardial infarction using an epicardial algorithm was first performed in a training set (n = 213) and tested in a validation set of patients (n = 214). The results from this epicardial algorithm in myocardial infarction detection were compared with the physician's interpretation of the 12-lead ECG, the body surface map algorithm (PRIME (TM)) and physician's interpretation of the body surface map. Results: Myocardial infarction occurred in 205 patients (creatine kinase >= 2 x upper limit of normal with creatine kinase-MB >= 7% CK). The physician's interpretation of the 12-lead ECG identified 122 with myocardial infarction (sensitivity 60%, specificity 99%), the body surface map algorithm 137 (sensitivity 67%, specificity 89%), the physician's interpretation of the body surface map 153 (sensitivity 75%, specificity 91%) and the epicardial algorithm 158 (sensitivity 77% specificity 99%). Combining the physician's interpretation of the 12-lead ECG with the epicardial algorithm increased significantly the detection of myocardial infarction (sensitivity 85%, specificity 98%, p < 0.001) compared with the 12-lead ECG. Conclusions: An epicardial algorithm based on epicardial potentials increases significantly the detection of myocardial infarction particularly among those with non-diagnostic 12-lead ECG's. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
LanguageEnglish
Pages292-301
JournalInternational Journal of Cardiology
Volume111
Issue number2
DOIs
Publication statusPublished - Aug 2006

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Myocardial Infarction
Electrocardiography
Physicians
Sensitivity and Specificity
MB Form Creatine Kinase
Lead
Acute Coronary Syndrome
Creatine Kinase
Chest Pain
Ireland

Keywords

  • myocardial infarction
  • epicardial algorithm
  • ventricular hypertrophy
  • epicardial potentials

Cite this

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title = "Improved detection of acute myocardial infarction using a diagnostic algorithm based on calculated epicardial potentials",
abstract = "Background: New methods for detecting myocardial infarction in patients with suspected acute coronary syndromes are needed particularly in an era where the majority of patients with myocardial infarction present with non-diagnostic 12-lead electrocardiograms (ECG). We compared a novel epicardial diagnostic algorithm using epicardial potentials from the 80-lead body surface map with other electrocardiographic techniques in detection of myocardial infarction. Methods: Between February 1999 and February 200 1, consecutive patients (n = 427) with ischemic type chest pain had an initial 12-lead ECG and body surface map recorded. Detecting myocardial infarction using an epicardial algorithm was first performed in a training set (n = 213) and tested in a validation set of patients (n = 214). The results from this epicardial algorithm in myocardial infarction detection were compared with the physician's interpretation of the 12-lead ECG, the body surface map algorithm (PRIME (TM)) and physician's interpretation of the body surface map. Results: Myocardial infarction occurred in 205 patients (creatine kinase >= 2 x upper limit of normal with creatine kinase-MB >= 7{\%} CK). The physician's interpretation of the 12-lead ECG identified 122 with myocardial infarction (sensitivity 60{\%}, specificity 99{\%}), the body surface map algorithm 137 (sensitivity 67{\%}, specificity 89{\%}), the physician's interpretation of the body surface map 153 (sensitivity 75{\%}, specificity 91{\%}) and the epicardial algorithm 158 (sensitivity 77{\%} specificity 99{\%}). Combining the physician's interpretation of the 12-lead ECG with the epicardial algorithm increased significantly the detection of myocardial infarction (sensitivity 85{\%}, specificity 98{\%}, p < 0.001) compared with the 12-lead ECG. Conclusions: An epicardial algorithm based on epicardial potentials increases significantly the detection of myocardial infarction particularly among those with non-diagnostic 12-lead ECG's. (c) 2005 Elsevier Ireland Ltd. All rights reserved.",
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Improved detection of acute myocardial infarction using a diagnostic algorithm based on calculated epicardial potentials. / Owens, C; Navarro, C; McClelland, A; Riddell, J; Escalona, OJ; Anderson, JMCC; Adgey, JAA.

In: International Journal of Cardiology, Vol. 111, No. 2, 08.2006, p. 292-301.

Research output: Contribution to journalArticle

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AU - Navarro, C

AU - McClelland, A

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AU - Escalona, OJ

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AU - Adgey, JAA

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N2 - Background: New methods for detecting myocardial infarction in patients with suspected acute coronary syndromes are needed particularly in an era where the majority of patients with myocardial infarction present with non-diagnostic 12-lead electrocardiograms (ECG). We compared a novel epicardial diagnostic algorithm using epicardial potentials from the 80-lead body surface map with other electrocardiographic techniques in detection of myocardial infarction. Methods: Between February 1999 and February 200 1, consecutive patients (n = 427) with ischemic type chest pain had an initial 12-lead ECG and body surface map recorded. Detecting myocardial infarction using an epicardial algorithm was first performed in a training set (n = 213) and tested in a validation set of patients (n = 214). The results from this epicardial algorithm in myocardial infarction detection were compared with the physician's interpretation of the 12-lead ECG, the body surface map algorithm (PRIME (TM)) and physician's interpretation of the body surface map. Results: Myocardial infarction occurred in 205 patients (creatine kinase >= 2 x upper limit of normal with creatine kinase-MB >= 7% CK). The physician's interpretation of the 12-lead ECG identified 122 with myocardial infarction (sensitivity 60%, specificity 99%), the body surface map algorithm 137 (sensitivity 67%, specificity 89%), the physician's interpretation of the body surface map 153 (sensitivity 75%, specificity 91%) and the epicardial algorithm 158 (sensitivity 77% specificity 99%). Combining the physician's interpretation of the 12-lead ECG with the epicardial algorithm increased significantly the detection of myocardial infarction (sensitivity 85%, specificity 98%, p < 0.001) compared with the 12-lead ECG. Conclusions: An epicardial algorithm based on epicardial potentials increases significantly the detection of myocardial infarction particularly among those with non-diagnostic 12-lead ECG's. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

AB - Background: New methods for detecting myocardial infarction in patients with suspected acute coronary syndromes are needed particularly in an era where the majority of patients with myocardial infarction present with non-diagnostic 12-lead electrocardiograms (ECG). We compared a novel epicardial diagnostic algorithm using epicardial potentials from the 80-lead body surface map with other electrocardiographic techniques in detection of myocardial infarction. Methods: Between February 1999 and February 200 1, consecutive patients (n = 427) with ischemic type chest pain had an initial 12-lead ECG and body surface map recorded. Detecting myocardial infarction using an epicardial algorithm was first performed in a training set (n = 213) and tested in a validation set of patients (n = 214). The results from this epicardial algorithm in myocardial infarction detection were compared with the physician's interpretation of the 12-lead ECG, the body surface map algorithm (PRIME (TM)) and physician's interpretation of the body surface map. Results: Myocardial infarction occurred in 205 patients (creatine kinase >= 2 x upper limit of normal with creatine kinase-MB >= 7% CK). The physician's interpretation of the 12-lead ECG identified 122 with myocardial infarction (sensitivity 60%, specificity 99%), the body surface map algorithm 137 (sensitivity 67%, specificity 89%), the physician's interpretation of the body surface map 153 (sensitivity 75%, specificity 91%) and the epicardial algorithm 158 (sensitivity 77% specificity 99%). Combining the physician's interpretation of the 12-lead ECG with the epicardial algorithm increased significantly the detection of myocardial infarction (sensitivity 85%, specificity 98%, p < 0.001) compared with the 12-lead ECG. Conclusions: An epicardial algorithm based on epicardial potentials increases significantly the detection of myocardial infarction particularly among those with non-diagnostic 12-lead ECG's. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

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