Detecting Right Ventricular Mi From A 12 Lead Ecg When Rv Leads Are Unavailable- A New Algorithm

Abstract

Coronary heart disease is the most common cardiovascular disease and the major cause of death in middle aged and older people. The presentation of acute myocardial infarction is different depending upon the coronary artery involved. In inferior wall MI the culprit vessel is either right coronary artery or left circumflex coronary artery which is usually confirmed with the help of percutaneous coronary angiogram. However, a 12 lead ECG is a rapid non-invasive tool that can predict the site of occlusion in the involved artery. Moreover, significant mortality has been observed in patients with inferior wall MI complicated with right ventricular and posterior wall MI. Early identification of the culprit artery in patients with symptoms of MI could reduce the time to reperfusion and permit a better risk stratification. Previously reported electrocardiographic (ECG) criteria to distinguish left circumflex (LCCA) and right coronary artery (RCA) occlusion in patients with acute inferior ST segment elevation myocardial infarction (STEMI) afford a modest diagnostic accuracy. This study aimed to develop a new algorithm overcoming limitations of previous studies. Clinical, ECG, and coronary angiographic data were analysed in 209 patients with acute inferior STEMI who underwent primary percutaneous coronary intervention.