Skip to main content
Journal cover image

Identification of the optimal electrocardiographic leads for detecting acute epicardial injury in acute myocardial infarction.

Publication ,  Journal Article
Aldrich, HR; Hindman, NB; Hinohara, T; Jones, MG; Boswick, J; Lee, KL; Bride, W; Califf, RM; Wagner, GS
Published in: Am J Cardiol
January 1, 1987

Current coronary care electrocardiographic (ECG) monitoring techniques are aimed at detection of cardiac arrhythmias rather than myocardial ischemia. However, in patients with acute myocardial infarction (AMI) who undergo reperfusion therapy, monitoring ST-segment deviation could provide an early noninvasive indicator of coronary artery reocclusion. In this study, the admission 12-lead ECGs of patients with initial AMI were used to propose optimal lead locations for ST-segment monitoring. The study population was selected from consecutive Duke University Medical Center admissions during 1965 to 1981 who met the following inclusion criteria: chest pain for no more than 8 hours, initial AMI documented by ECG and 3 of 4 enzyme criteria, greater than or equal to 0.1 mV (1 mV = 10 mm) of ST elevation in at least 1 of the standard 12 leads (not aVR) on admission ECG, and no ECG evidence of conduction disturbances, ventricular hypertrophy or tachycardia. ST-segment deviation was quantified; AMI location was assigned based on the lead with maximal deviation. Of the 80 patients who had an inferior AMI, lead III was both the most frequent location for ST elevation (94%) and the most common site with maximal ST deviation. Lead V2 had the highest incidence of ST-segment depression (60%). In the 68 patients who had an anterior AMI, lead V2 had the highest frequency of ST elevation (99%). Leads V2 and V3 were the most common sites of maximal elevation. Thus, for monitoring ST deviation, leads III and V2 may be superior to leads II and V1, which are commonly used in arrhythmia monitoring.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

January 1, 1987

Volume

59

Issue

1

Start / End Page

20 / 23

Location

United States

Related Subject Headings

  • Recurrence
  • Pericardium
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electrocardiography
  • Coronary Disease
  • Cardiovascular System & Hematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Aldrich, H. R., Hindman, N. B., Hinohara, T., Jones, M. G., Boswick, J., Lee, K. L., … Wagner, G. S. (1987). Identification of the optimal electrocardiographic leads for detecting acute epicardial injury in acute myocardial infarction. Am J Cardiol, 59(1), 20–23. https://doi.org/10.1016/s0002-9149(87)80062-0
Aldrich, H. R., N. B. Hindman, T. Hinohara, M. G. Jones, J. Boswick, K. L. Lee, W. Bride, R. M. Califf, and G. S. Wagner. “Identification of the optimal electrocardiographic leads for detecting acute epicardial injury in acute myocardial infarction.Am J Cardiol 59, no. 1 (January 1, 1987): 20–23. https://doi.org/10.1016/s0002-9149(87)80062-0.
Aldrich HR, Hindman NB, Hinohara T, Jones MG, Boswick J, Lee KL, et al. Identification of the optimal electrocardiographic leads for detecting acute epicardial injury in acute myocardial infarction. Am J Cardiol. 1987 Jan 1;59(1):20–3.
Aldrich, H. R., et al. “Identification of the optimal electrocardiographic leads for detecting acute epicardial injury in acute myocardial infarction.Am J Cardiol, vol. 59, no. 1, Jan. 1987, pp. 20–23. Pubmed, doi:10.1016/s0002-9149(87)80062-0.
Aldrich HR, Hindman NB, Hinohara T, Jones MG, Boswick J, Lee KL, Bride W, Califf RM, Wagner GS. Identification of the optimal electrocardiographic leads for detecting acute epicardial injury in acute myocardial infarction. Am J Cardiol. 1987 Jan 1;59(1):20–23.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

January 1, 1987

Volume

59

Issue

1

Start / End Page

20 / 23

Location

United States

Related Subject Headings

  • Recurrence
  • Pericardium
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electrocardiography
  • Coronary Disease
  • Cardiovascular System & Hematology