title: Reliability of ST-segment shifts in the synthesized V₃R-V₅R leads after coronary balloon inflations during percutaneous coronary intervention.
abstract: Obtaining a right-chest electrocardiogram is essential for diagnosing concomitant right ventricular infarction in patients with inferior wall acute myocardial infarctions. A software program to synthesize right-chest electrocardiographic waveforms from 12-lead electrocardiographic waveforms is available in Japan. However, its reliability has not been fully investigated. Accordingly, the aim of this study was to examine the reliability of ST-segment shifts in the synthesized V3R to V5R leads. ST-segment shifts in actual and synthesized V3R to V5R leads were compared during the last 10 seconds of 131 balloon inflations while performing elective percutaneous coronary intervention in 56 patients with coronary artery disease. ST-segment shifts in the actual and synthesized V3R, V4R, and V5R leads were correlated (r = 0.96, p <0.001, r = 0.94, p <0.001, and r = 0.91, p <0.001, respectively). A Bland-Altman analysis showed that the bias between ST-segment shifts in the actual and synthesized V3R to V5R leads was -3.1, -5.4, and -4.2 μV, respectively, while the limits of agreement between the ST-segment shifts in the actual and synthesized V3R to V5R leads were -59.2 to 52.9, -61.9 to 51.1, and -59.7 to 51.3 μV, respectively. The κ coefficients for ST-segment elevation of ≥50 and ≥100 μV in the actual and synthesized V3R, V4R, and V5R leads were 0.83 and 0.81, 0.66 and 0.83, and 0.57 and 0.80, respectively. In conclusion, these results indicate that ST-segment shifts in the synthesized V3R to V5R leads have acceptable reliability, suggesting that synthesized right-chest electrocardiography can be used to diagnose concomitant right ventricular infarction in patients with inferior wall acute myocardial infarctions.
authors.affiliation: Department of Cardiology and Clinical Examination, Oita University, Yufu, Japan. Electronic address: akira@oita-u.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Tamura
authors.affiliation: Department of Cardiology and Clinical Examination, Oita University, Yufu, Japan.
authors.forename: Kumie
authors.initials: K
authors.lastname: Torigoe
authors.affiliation: Division of Cardiovascular Medicine, Koseiren Tsurumi Hospital, Beppu, Japan.
authors.forename: Yukie
authors.initials: Y
authors.lastname: Goto
authors.affiliation: Division of Cardiovascular Medicine, Koseiren Tsurumi Hospital, Beppu, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Naono
authors.affiliation: Division of Cardiovascular Medicine, Koseiren Tsurumi Hospital, Beppu, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shinozaki
authors.affiliation: Division of Cardiovascular Medicine, Koseiren Tsurumi Hospital, Beppu, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Zaizen
authors.affiliation: Department of Cardiology and Clinical Examination, Oita University, Yufu, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D018450:Disease Progression; D017558:Elective Surgical Procedures; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D015607:Stents; D015996:Survival Rate / Q000639:trends