Key result
Proposed vectorcardiogram criteria successfully diagnosed old inferior myocardial infarction in 90% of cases, compared to 42% using classical ECG criteria.
Why the study?
Does the frontal plane vectorcardiogram improve the diagnosis of old inferior myocardial infarction compared to standard ECG criteria?
Observational (n=415)
Does the frontal plane vectorcardiogram improve the diagnosis of old inferior myocardial infarction compared to standard ECG criteria?
The frontal plane vectorcardiogram is substantially more sensitive than standard ECG criteria for detecting old inferior myocardial infarction.
Answers are grounded in this paper and cite their sources.
Early QRS vector analysis may refine old inferior MI diagnosis; leaves open validation in contemporary cohorts.
The early part of the frontal plane QRS loop (Frank lead system) was analyzed in 100 consecutive patients with an old inferior myocardial infarction. In order to be included in this study, all cases had to fulfill, at some time, Myers' classical ECG criteria for the diagnosis. The vectorcardiogram was made months to years after the patient's original acute episode. Several scalar and planar parameters, pertaining to these frontal plane early QRS vectors, were analyzed. As a result of this analysis and in order to prevent overlap with values found in 315 normal control subjects, VCG criteria, based on the interrelationships of several of these parameters, were proposed for the diagnosis of old inferior myocardial infarction. Pitfalls in the use of only scalar or planar analyses were pointed out. In 90 of the 100 cases the diagnosis was made on the basis of the proposed VCG criteria. However, the ECG made at the same time fulfilled Myers' or Goldberger's classical criteria in only 42 of the 100 cases. All cases diagnosed from the ECG were also diagnosed from the VCG.
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Young et al. (1968) conducted an observational in Old inferior myocardial infarction (n=415). Vectorcardiogram (VCG) criteria vs. Classical ECG criteria was evaluated on Diagnosis of old inferior myocardial infarction. Proposed vectorcardiogram criteria successfully diagnosed old inferior myocardial infarction in 90% of cases, compared to 42% using classical ECG criteria.
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