title: Diagnostic accuracy of a novel method for detection of acute transmural myocardial ischemia based upon a self-applicable 3-lead configuration.
abstract: BACKGROUND
  Delayed medical attendance is a leading cause of death in patients with ST elevation myocardial infarction (STEMI).
  
  
  METHODS
  We aimed to introduce, develop, and validate a novel method (RELF method) for detection of transmural ischemia based on a new and easy-to-use 3-lead configuration and orthonormalization of ST reference vectors (STDVN). The study included 60 patients undergoing coronary artery occlusion (CAO) during balloon inflation and 30 healthy subjects.
  
  
  RESULTS
  STDVN was significantly different and an optimal discriminator between CAO patients and healthy subjects (respectively 8.00±4.50 vs. 1.90±0.86 normalized units, p<0.001). Compared to the 12-lead ECG, the RELF method was sensitive (90 vs. 73%, p=0.13) and more specific (91 vs. 75%, p<0.001).
  
  
  CONCLUSIONS
  The RELF method is highly accurate for early detection of acute occlusion related ischemia and it outperforms the conventional 12-lead ECG criteria for STEMI. This method provides a platform for self-detection of CAO with handheld devices or smart phones.
authors.affiliation: Department of Cardiology, Heart Center, Ghent University Hospital, Ghent, Belgium.
authors.forename: Milad
authors.initials: M
authors.lastname: El Haddad
authors.affiliation: Department of Cardiology, Heart Center, Ghent University Hospital, Ghent, Belgium.
authors.forename: Delphine
authors.initials: D
authors.lastname: Vervloet
authors.affiliation: Department of Cardiology, Heart Center, Ghent University Hospital, Ghent, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Taeymans
authors.affiliation: Department of Cardiology, Heart Center, Ghent University Hospital, Ghent, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: De Buyzere
authors.affiliation: Department of Cardiology, Heart Center, Ghent University Hospital, Ghent, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Bové
authors.affiliation: Department of Cardiology, Heart Center, Ghent University Hospital, Ghent, Belgium.
authors.forename: Roland
authors.initials: R
authors.lastname: Stroobandt
authors.affiliation: Department of Cardiology, Heart Center, Ghent University Hospital, Ghent, Belgium.
authors.forename: Mattias
authors.initials: M
authors.lastname: Duytschaever
authors.affiliation: Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Malmivuo
authors.affiliation: Department of Cardiology, Heart Center, Ghent University Hospital, Ghent, Belgium. Electronic address: peter.gheeraert@ugent.be.
authors.forename: Peter
authors.initials: P
authors.lastname: Gheeraert
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D063731:Mobile Applications; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D012648:Self Care / Q000295:instrumentation / Q000379:methods*; D012680:Sensitivity and Specificity; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*
keywords: Diagnosis; Electrocardiography; Heart arrest; Myocardial infarction