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Comprehensive evaluation of electrocardiographic methods for detection of myocardial infarction
Authors:M.D. Jeffrey B. Ritterman   M.D. Kenneth F. Hossack   M.D. Bert Green  M.D.   F.A.C.C. Robert A. Bruce  
Abstract:
In two groups of patients the detection of myocardial infarction (MI) by analysis of four different electrocardiographic methods was evaluated. The various methods included the conventional 12 lead ECG (CV-ECG), the 12 lead ECG derived from Frank XYZ lead system signals (D-ECG), the polarcardiogram (PCG) and the vectorcardiogram (VCG). An invasive group consisted of 137 patients who had undergone cardiac catheterization. An MI was defined as a regional wall motion abnormality in the distribution of a coronary artery with at least 70% diameter reduction. The noninvasive group consisted of 116 patients in whom independent clinical information was limited to noninvasive assessments. In this group, Telemed Computer Systems' interpretation of the conventional (TC-ECG) and derived (TD-ECG) electrocardiogram was also available for comparison. An MI was defined in this group as either a compatible history with documented cardiac enzyme elevations, a resting defect on thallium scan, or a regional wall motion abnormality in a resting, radionuclide isotope ventriculogram. In this study the other methods of ECG evaluation demonstrated no advantage over the electrocardiographer's reading of the conventional ECG.
Keywords:Reprint requests to: Robert A. Bruce   M.D.   Division of Cardiology   RG-20   University Hospital   University of Washington   Seattle   WA 98195.
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