Open AccessEvaluation of QRST isointegral maps in detecting posterior myocardial infarction with and without conduction disturbance
Author(s) -
Agetsuma Hirotaka,
Suzuki Akira,
Hiral Makoto,
Sano Hiroaki,
Tomita Yasushi,
Ichihara Yoshio,
Adachi Masayoshi,
Takatsu Fumimaro,
Hayashi Hiroshi
Publication year - 1995
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960180207
Subject(s) - medicine , cardiology , sinus rhythm , myocardial infarction , left bundle branch block , disturbance (geology) , intraventricular conduction , bundle branch block , electrocardiography , nuclear medicine , heart failure , atrial fibrillation , paleontology , biology
We investigated the usefulness of QRST isointegral maps (I‐maps) for detecting posterior myocardial infarction (MI) with and without conduction disturbance. The I‐maps were recorded during sinus rhythm and right ventricular (RV) pacing, which simulated left bundle‐branch block (LBBB) in 19 patients with and in 20 patients without MI. Data on 608 normal subjects were used as controls. The “‐2 SD area,” where the QRST integral value was less than the lower limit of the normal range, was assessed by ΣDM (sum of QRST integral values below the normal range). Posterior MI was diagnosed with a sensitivity of 84%, a specificity of 90%, and a diagnostic accuracy of 87%, assuming that MI was present if ΣDM exceeded 50 mVms. During simulated LBBB, when the criterion ΣDM more than 250 mVms was used, the sensitivity, specificity, and diagnostic accuracy were 79, 75, and 77%, respectively. Thus, I‐maps may be useful in detecting posterior MI in patients with and without an intraventricular conduction disturbance.