title: A 12-lead ECG-method for quantifying ischemia-induced QRS prolongation to estimate the severity of the acute myocardial event.
abstract: Studies have shown terminal QRS distortion and resultant QRS prolongation during ischemia to be a sign of low cardiac protection and thus a faster rate of myocardial cell death. A recent study introduced a single lead method to quantify the severity of ischemia by estimating QRS prolongation. This paper introduces a 12-lead method that, in contrast to the previous method, does not require access to a prior ECG.
  
  
  
  QRS duration was estimated in the lead that showed the maximal ST deviation according to a novel method. The degree of prolongation was determined by subtracting the measured QRS duration in the lead that showed the least ST deviation.
  
  
  
  The method is demonstrated in examples of acute occlusion in two of the major coronary arteries.
  
  
  
  This paper presents a 12-lead method to quantify the severity of ischemia, by measuring QRS prolongation, without requiring comparison with a previous ECG.
authors.affiliation: Department of Clinical Physiology, Blekingesjukhuset, Karlskrona, Sweden.
authors.forename: Viktor
authors.initials: V
authors.lastname: Elmberg
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital and Lund University, Lund, Sweden.
authors.forename: Jakob
authors.initials: J
authors.lastname: Almer
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital and Lund University, Lund, Sweden.
authors.forename: Olle
authors.initials: O
authors.lastname: Pahlm
authors.affiliation: Duke University Medical Center, Durham, NC, USA.
authors.forename: Galen S
authors.initials: GS
authors.lastname: Wagner
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital and Lund University, Lund, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Engblom
authors.affiliation: Thoracic Center, Blekingesjukhuset, Karlskrona, Sweden. Electronic address: michaelringborn@yahoo.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Ringborn
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
keywords: Acute myocardial infarction; ECG; Electrocardiography; Ischemia; Severity of ischemia