Electrocardiographic diagnosis of atrial infarction in patients with acute inferior ST‐segment elevation myocardial infarction |
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| Authors: | Suleyman Sezai Yıldız Kudret Keskin Murat Avsar Gokhan Cetinkal Serhat Sigirci Gokhan Aksan Sukru Cetin Ertugrul Okuyan Kadriye Orta Kilickesmez |
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| Affiliation: | 1. Department of Cardiology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey;2. Department of Cardiology, Yedikule Chest Disease and Thoracic Surgery Training Hospital, University of Health Sciences, Istanbul, Turkey;3. Department of Cardiology, Bagcilar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey |
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| Abstract: | Background Patients with atrial myocardial infarction (ATMI) have frequent cardiac and noncardiac complications. However, ATMI is uncommonly diagnosed because of its nonspecific ECG changes. Our objective was to analyze the ECG characteristics of ATMI in patients with inferior STEMI. Hypothesis Electrocardiographic P wave parameters can help in diagnosis of ATMI. Methods We evaluated 932 patients who underwent coronary angiography and recruited 39 patients with ATMI and 33 patients without ATMI with inferior STEMI for a retrospective study. Twelve‐lead ECGs were obtained to measure P‐wave parameters in diagnosis of ATMI. P‐wave parameters and PR‐segment displacement were compared in patients with and without ATMI. Results In inferior leads, PWD and PWDisp were significantly longer in the ATMI group than in the non‐ATMI group (limb lead II, 109.79 ±15.51 ms and 86.65 ±5.02 ms, respectively; P < 0.001; limb lead III, 108.31 ±12.51 ms and 85.27 ±7.47 ms, P < 0.001; aVF, 106.49 ±13.68 ms and 83.01 ±7.89 ms, P < 0.001; PWDisp, 41.67 ±10.72 ms and 25.18 ±5.17 ms, P < 0.001). By contrast, PWA was significantly lower in the ATMI group than in the non‐ATMI group (limb lead II, 0.96 ±0.18 mV and 1.39 ±0.22 mV, respectively; P < 0.001; limb lead III, 0.90 ±0.11 and 1.21 ±0.23, P < 0.001; aVF, 0.88 ±0.17 and 1.26 ±0.28, P < 0.001). PR‐segment displacement was found in 8 (20.5%) patients with ATMI. A PWD ≥95.5 ms in lead DII diagnosed ATMI with a higher sensitivity and specificity (90%, 94%) than did PWA or PWDisp. Conclusions This study suggests P‐wave parameters might be considered ECG findings in diagnosis of ATMI in patients with inferior STEMI. |
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