Key result
Admission J-point/R-wave ratio ≥0.5 predicts ~4.5-fold higher risk of 24-hour high-degree AV block in inferior MI.
Why the study?
The ability of simple clinical and ECG variables on admission to predict high-degree AV block in inferior myocardial infarction patients within 24 hours was unclear.
Does an admission ECG J-point/R-wave ratio >= 0.5 predict high-degree AV block in patients with inferior acute myocardial infarction?
Population
205 patients with inferior myocardial infarction
Comparison
Admission ECG with J-point/R-wave ratio ≥0.5 in ≥2 inferior leads vs <0.5
Design
Cohort study
Follow-up
24 hours
Authors
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Admission ECG J-point/R-wave patterns may stratify early high-degree AV block risk in inferior MI; hypothesis-generating and needs prospective validation before practice change.
Cohort (n=205)
Does an admission ECG J-point/R-wave ratio >= 0.5 predict high-degree AV block in patients with inferior acute myocardial infarction?
Odds Ratio: 4.47 (95% CI 1.18–16.9)
Absolute Event Rate: 16% vs 5%
p-value: p=0.0276
A J-point/R-wave ratio >= 0.5 on admission ECG is a strong independent predictor of early high-degree AV block in patients with inferior acute myocardial infarction.
Solodky et al. (1998) conducted a cohort in Inferior acute myocardial infarction (n=205). Admission ECG J-point/R-wave ratio ≥0.5 in ≥2 inferior leads (Pattern 2) vs. Admission ECG J-point/R-wave ratio <0.5 (Pattern 1) was evaluated on Development of high-degree atrioventricular block within the first 24 h of hospitalization (OR 4.47, 95% CI 1.18-16.9, p=0.0276). An admission ECG J-point/R-wave ratio ≥0.5 independently predicted the development of high-degree AV block within 24 hours in patients with inferior MI (OR 4.47; 95% CI 1.18-16.9; p=0.0276).
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