Enhancing the Accuracy of Computerized Interpretation of Old Inferior Wall Myocardial Infarction in a Routine or Preoperative Electrocardiogram by Analyzing Repolarization Abnormalities and Q Waves in Leads II, III and aVF

Zameer Abedin; David Gough; Moeen Abedin; Siddiqui Tariq; Mukherjee Debabrata; Ojha Chandra P; Mulla Zuber D; Zainul Abedin

doi:10.23937/2378-2951/1410196

August 14, 2020International Journal of Clinical CardiologyOpen Access

Enhancing the Accuracy of Computerized Interpretation of Old Inferior Wall Myocardial Infarction in a Routine or Preoperative Electrocardiogram by Analyzing Repolarization Abnormalities and Q Waves in Leads II, III and aVF

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Why the study?

A computerized interpretation diagnosis of old inferior wall myocardial infarction on routine ECG can lead to further consultations and imaging studies to confirm or refute the finding.

Does manual analysis of Q waves and repolarization abnormalities improve the positive predictive value of computerized ECG interpretation for diagnosing old inferior wall myocardial infarction in patients with a computer-generated diagnosis?

Structured PICO

Does manual analysis of Q waves and repolarization abnormalities improve the positive predictive value of computerized ECG interpretation for diagnosing old inferior wall myocardial infarction in patients with a computer-generated diagnosis?

P

Population

56 patients with a computer-generated diagnosis of an old inferior wall myocardial infarction (IMI) on an electively performed 12-lead ECG and availability of an echocardiogram, coronary angiogram, or nuclear perfusion scan performed in the last one year. Average age 63 years, 67.8% male.

I

Intervention

Manual measurement of Q waves (duration ≥ 40 msec and amplitude ≥ -0.2 mV) combined with repolarization abnormalities (ST segment deviation > 1 mm and T wave polarity) in at least two of the three inferior leads (II, III, aVF)

C

Comparator

Computerized interpretation of the ECG alone (MUSE GE system)

O

Outcome

Positive predictive value (PPV) for the diagnosis of old IMI as confirmed by imaging studiessurrogate

Adding manual analysis of Q waves and repolarization abnormalities in inferior leads significantly improves the positive predictive value of computerized ECG interpretation for diagnosing old inferior wall myocardial infarction, potentially reducing unnecessary imaging and consultations.

Limitations

Retrospective study design
Small number of patients who had at least one imaging study to be included

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Implication

May raise PPV for old inferior MI on ECG overreads; hypothesis-generating for clinical adoption.

Abstract

A diagnosis of an old inferior wall myocardial infarction (IMI) by computerized interpretation of a routinely performed electrocardiogram (ECG) may lead to further consultations and imaging studies to confirm or refute that diagnosis.

Discussion

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Cite This Study

Abedin et al. (2020) studied this question.

synapsesocial.com/papers/6a8c7dbe914e3f490bf6b1b7 https://doi.org/10.23937/2378-2951/1410196

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Enhancing the Accuracy of Computerized Interpretation of Old Inferior Wall Myocardial Infarction in a Routine or Preoperative Electrocardiogram by Analyzing Repolarization Abnormalities and Q Waves in Leads II, III and aVF

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Enhancing the Accuracy of Computerized Interpretation of Old Inferior Wall Myocardial Infarction in a Routine or Preoperative Electrocardiogram by Analyzing Repolarization Abnormalities and Q Waves in Leads II, III and aVF

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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