The case highlights the clinical challenge of diagnosing myocardial ischemia via ECG in patients with biventricular-paced rhythms.
ECG diagnosis of MI may be altered by biventricular pacing; leaves open validation of specific criteria.
Pacemakers devaluate the accuracy of the electrocardiogram (ECG) for the diagnosis of myocardial ischaemia. We present the case of a 53-year-old man with ischaemic cardiomyopathy and acute chest pain. Besides biventricular pacing, new ST-segment elevations were present leading to the diagnosis of myocardial infarction. However, no ECG criteria for the diagnosis of myocardial ischaemia in biventricular-paced rhythm are available.
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Ukena et al. (2011) studied this question.
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