Single-lead electrocardiographic variables in the detection of prior myocardial infarction with respect to Q-wave status and infarct age.
OBJECTIVE
Conventionally, the detection of prior myocardial infarction (MI) is based on QRS abnormalities, which may ignore non-Q-wave MI (NQMI). We aimed at finding automatically applicable quantitative ECG variables for diagnosing prior MI.


METHODS
Body surface potential mapping (BSPM) was registered and automatically analyzed in 144 patients with prior MI and in 75 healthy controls. The MI was defined according to its age as recent or old, and Q-wave status as Q-wave MI (QMI) or NQMI.


RESULTS
The QRSSTT integral, the STT integral and the T-wave apex amplitude applied in single, selected leads were found to be the optimal parameters in the detection of prior MI. The areas under the receiver-operating characteristic curves (AUC) were 89% for each, and detection was equal in old and recent MI (AUCs from 87 to 90%), and in QMI and NQMI (AUCs from 88 to 90%).


CONCLUSIONS
The quantitative, automatically applicable single-lead variables comprising ventricular repolarization was effective in detecting prior MI, irrespective of the time elapsed from MI or the Q-wave status. These variables could be suitable for population studies and health screening purposes and are applicable to automatic ECG diagnostics of prior MI.
Vesterinen
Paula
P
Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland. paula.vesterinen@kolumbus.fi
Väänänen
Heikki
H
Hänninen
Helena
H
Korhonen
Petri
P
Tierala
Ilkka
I
Husa
Terhi
T
Mäkijärvi
Markku
M
Toivonen
Lauri
L
D000328:Adult; D000367:Age Factors; D000368:Aged; D018780:Body Surface Potential Mapping; D016022:Case-Control Studies; D005260:Female; D006329:Heart Conduction System; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity