Diagnostic Accuracy of the Electrocardiographic Decision Support – Myocardial Ischaemia (EDS-MI) Algorithm in Detection of Acute Coronary Occlusion

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Lindow, ThomasLund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Växjö Central Hospital,Skåne University Hospital (author)

Diagnostic Accuracy of the Electrocardiographic Decision Support – Myocardial Ischaemia (EDS-MI) Algorithm in Detection of Acute Coronary Occlusion

Article/chapterEnglish2020

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2018-04-03
Oxford University Press (OUP),2020
13 s.

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LIBRIS-ID:oai:lup.lub.lu.se:cf1e6fa6-f8d1-48c5-aadd-de44ad6d9a56
https://lup.lub.lu.se/record/cf1e6fa6-f8d1-48c5-aadd-de44ad6d9a56URI
https://doi.org/10.1177/2048872618768081DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype
Subject category:ref swepub-contenttype

Notes

Electrocardiographic Decision Support - Myocardial Ischaemia (EDS-MI) is a graphical decision support for detection and localization of acute transmural ischaemia. A recent study indicated that EDS-MI performs well for detection of acute transmural ischaemia. However, its performance has not been tested in patients with non-ischaemic ST-deviation. We aimed to optimize the diagnostic accuracy of EDS-MI in patients with verified acute coronary occlusion as well as patients with non-ischaemic ST deviation and compare its performance with STEMI criteria. We studied 135 patients with non-ischaemic ST deviation (perimyocarditis, left ventricular hypertrophy, takotsubo cardiomyopathy and early repolarization) and 117 patients with acute coronary occlusion. In 63 ischaemic patients, the extent and location of the ischaemic area (myocardium at risk) was assessed by both cardiovascular magnetic resonance imaging and EDS-MI. Sensitivity and specificity of ST elevation myocardial infarction criteria were 85% (95% confidence interval (CI) 77, 90) and 44% (95% CI 36, 53) respectively. Using EDS-MI, sensitivity and specificity increased to 92% (95% CI 85, 95) and 81% (95% CI 74, 87) respectively (p=0.035 and p<0.001). Agreement was strong (83%) between cardiovascular magnetic resonance imaging and EDS-MI in localization of ischaemia. Mean myocardium at risk was 32% (± 10) by cardiovascular magnetic resonance imaging and 33% (± 11) by EDS-MI when the estimated infarcted area according to Selvester QRS scoring was included in myocardium at risk estimation. In conclusion, EDS-MI increases diagnostic accuracy and may serve as an automatic decision support in the early management of patients with suspected acute coronary syndrome. The added clinical benefit in a non-selected clinical chest pain population needs to be assessed.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Radiologi och bildbehandling hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Radiology, Nuclear Medicine and Medical Imaging hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Annan klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Other Clinical Medicine hsv//eng
ECG
Electrocardiography
Acute coronary occlusion
EKG
Elektrokardiografi

Added entries (persons, corporate bodies, meetings, titles ...)

Pahlm, OlleLund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)klfy-opa (author)
Olson, Charles WECG-TECH Corp (author)
Khoshnood, ArdavanLund University,Lunds universitet,Medicin, Lund,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medicine, Lund,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-akh (author)
Ekelund, UlfLund University,Lunds universitet,Medicin, Lund,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Experimentell kärlforskning,Forskargrupper vid Lunds universitet,Medicine, Lund,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Experimental Vascular Research,Lund University Research Groups(Swepub:lu)mphy-uek (author)
Carlsson, MarcusLund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital(Swepub:lu)klin-mca (author)
Swenne, Cees A.Leiden University Medical Centre (author)
Man, SumcheLeiden University Medical Centre (author)
Engblom, HenrikLund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Cardiac MR Group,Lund University Research Groups(Swepub:lu)klin-hen (author)
Klinisk fysiologi, LundSektion V (creator_code:org_t)

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In:European Heart Journal: Acute Cardiovascular Care: Oxford University Press (OUP)9:S1, s. 13-252048-87342048-8726

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