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- Hedén, Bo, et al.
(författare)
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A modified Anderson-Wilkins electrocardiographic acuteness score for anterior or inferior myocardial infarction.
- 2003
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Ingår i: American Heart Journal. - 1097-6744. ; 146:5, s. 797-803
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Tidskriftsartikel (refereegranskat)abstract
- Background Optimal treatment of acute myocardial infarction (AMI) depends on the duration of the ischemia. The Anderson Wilkins (AW) electrocardiographic acuteness score has been shown to complement the historical timing in estimating the time interval from acute thrombotic coronary occlusion in patients presenting with chest pain and evolving myocardial infarction. The purposes of this study were to (1) compare the distributions of the previously developed AW acuteness score in a training population with either anterior or inferior AMI and (2) propose modifications to the formula to achieve distributions similar to the observed distributions of historical times from onset of pain. Methods Two hundred three and 177 patients were included as training and testing population, respectively. All patients had an anterior or an inferior AMI and were without confounding factors on the electrocardiogram. Results The training population had similar distributions of historical times from onset of pain, but differences in distributions of AW acuteness scores, between patients with anterior and inferior AMI (P<.0001). Eighty percent of the inferior AMI group had the highest possible AW acuteness score. Modification of a Q-wave criterion from &GE;30 to &GE;20 ms resulted in similar distributions in patients with anterior and inferior AMI both in the training and an independent testing population. Conclusions These results suggest that a modified AW acuteness score using a lower Q-wave duration criterion provides similar AMI timing information in patients with anterior and inferior locations. Clinical use of the AW acuteness score will only be practical if the calculation is automated
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- Wagner, Galen S., et al.
(författare)
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A method for assembling a collaborative research team from multiple disciplines and academic centers to study the relationships between ECG estimation and MRI measurement of myocardial infarct size
- 2001
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Ingår i: Journal of Electrocardiology. - : Elsevier BV. - 1532-8430 .- 0022-0736. ; 34:4 Suppl 1, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- A method has been developed for establishing a "University Without Walls" for the purpose of studying the relationship between electrocardiographic estimation and magnetic resonance imaging measurements of myocardial infarct size. The research team includes faculty and students from 4 medical centers, with expertise extending from clinical to technical. Weekly interactive videoconferences provide the key research communication method. Study patients are recruited from 2 of the sites, and the correlations between their electrocardiographic and magnetic resonance imaging data are considered by the research team in conference. Outcomes of this program are both scientific publications in international peer-review journals and formal postdoctoral degree attainment by the research trainees.
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| 4. |
- Dowdy, Lauren, et al.
(författare)
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Early repolarization: friend or foe?
- 2003
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Ingår i: The American journal of medicine. - 0002-9343. ; 115:3, s. 237-40
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Johanson, Per, 1963, et al.
(författare)
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ST-segment monitoring in patients with acute coronary syndromes.
- 2003
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Ingår i: Current cardiology reports. - 1523-3782. ; 5:4, s. 278-83
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Forskningsöversikt (refereegranskat)abstract
- ST-segment analyses from electrocardiograms during acute coronary syndromes (ACS) have repeatedly shown strong mechanistic links to coronary artery patency and myocardial reperfusion. In these patients, such analyses have also consistently been reported to have close correlations with outcome--correlations superior even to those reported for invasive coronary flow measurements and outcome. Continuous multilead ST-monitoring of patients with ACS provides accurate and noninvasive information on the dynamics of the myocardial reperfusion process over time. This information can be used for improved early diagnostic accuracy, evaluation of treatment efficacy, early risk-stratification, and can be supportive in clinical decision making regarding these patients. Continuous multilead ST-monitoring during ACS is no longer a cumbersome source of more nuisance than benefit, but can be an accurate and useful tool in multicenter clinical trials, as well as in clinical medicine.
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| 9. |
- Pettersson, Jonas, et al.
(författare)
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Changes in high-frequency QRS components are more sensitive than ST segment deviation for detecting acute coronary artery occlusion
- 2000
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Ingår i: Journal of the American College of Cardiology. - 0735-1097. ; 36:6, s. 1827-1834
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES This study describes changes in high-frequency QRS components (HF-QRS) during percutaneous transluminal coronary angioplasty (PTCA) and compares the ability of these changes in HF-QRS and ST-segment deviation in the standard 12-lead electrocardiogram (ECG) to detect acute coronary artery occlusion. BACKGROUND Previous studies have shown decreased HF-QRS in the frequency range of 150–250 Hz during acute myocardial ischemia. It would be important to know whether the high-frequency analysis could add information to that available from the ST segments in the standard ECG. METHODS The study population consisted of 52 patients undergoing prolonged balloon occlusion during PTCA. Signal-averaged electrocardiograms (SAECG) were recorded prior to and during the balloon inflation. The HF-QRS were determined within a bandwidth of 150–250 Hz in the preinflation and inflation SAECGs. The ST-segment deviation during inflation was determined in the standard frequency range. RESULTS The sensitivity for detecting acute coronary artery occlusion was 88% using the high-frequency method. In 71% of the patients there was ST elevation during inflation. If both ST elevation and depression were considered, the sensitivity was 79%. The sensitivity was significantly higher using the high-frequency method, p < 0.002, compared with the assessment of ST elevation. CONCLUSIONS Acute coronary artery occlusion is detected with higher sensitivity using high-frequency QRS analysis compared with conventional assessment of ST segments. This result suggests that analysis of HF-QRS could provide an adjunctive tool with high sensitivity for detecting acute myocardial ischemia.
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| 10. |
- Ringborn, Michael, et al.
(författare)
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The absence of high-frequency QRS changes in the presence of standard electrocardiographic QRS changes of old myocardial infarction
- 2001
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Ingår i: American Heart Journal. - : Elsevier BV. - 1097-6744 .- 0002-8703. ; 141:4, s. 573-579
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study compares the high-frequency QRS components (HF-QRS) in patients with and without standard electrocardiogram (ECG) changes indicative of old myocardial infarction (MI). Previous studies have indicated that patients with an old MI differ in their HF-QRS compared with healthy subjects. The HF-QRS has been reported to be decreased during acute coronary occlusion and increased after reperfusion. However, there is controversy about the appearance of HF-QRS after the acute phase of MI. METHODS: A total of 154 patients were included, 57 with and 97 without QRS changes of old MI on the standard ECG. The patients with old MI were divided into subgroups on the basis of the MI location indicated by the standard ECG. Signal-averaged ECGs from the 12 standard leads were recorded. The root-mean-square values of the HF-QRS were determined within two frequency bands: 150 to 250 Hz and 80 to 300 Hz. RESULTS: There was a large interindividual variation in HF-QRS in patients without MI as well as in those with different MI locations. There were no significant differences between the groups in the summed HF-QRS of all 12 leads or in the pattern of lead distribution of the HF-QRS. Not even the patients with the greatest QRS changes of old MI could be differentiated from those without any changes of old MI on the standard ECG. The results were the same in both analyzed frequency bands. CONCLUSIONS: This study shows, contrary to previous studies, that analysis of HF-QRS cannot differentiate between patients with and without old MI.
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