The 24-lead and 19-lead admission ECGs increased sensitivity for detecting acute myocardial infarction to 49% and 45%, respectively, compared to 33% for the conventional 12-lead ECG.
Observational (n=479)
No
Does the use of 16-lead, 19-lead, or 24-lead ECG improve the diagnostic accuracy for acute myocardial infarction compared to conventional 12-lead ECG in patients with acute chest pain?
The use of 19-lead or 24-lead ECGs (derived from standard 12-lead data by inverting leads) significantly increases the sensitivity for detecting acute myocardial infarction without requiring additional electrodes, though with a slight decrease in specificity.
Absolute Event Rate: 49% vs 33%
Summary Background: The electrocardiographic (ECG) diagnosis of acute myocardial infarction (MI) should be improved. This might be done either by regarding all 24 aspects (both positive and negative leads), or a subset hereof (e.g. 19‐lead ECG), of the conventional 12‐lead ECG or by using additional electrodes. The purpose of this study was to investigate the accuracy of the different ECG methods in diagnosing acute ST‐elevation MI. Methods: The study population consisted of 479 patients admitted to Lund University Hospital with acute chest pain. One conventional ECG plus leads V4R, V5R, V8 and V9 were recorded for each patient within 24 h of admittance. Biochemical markers were used as the ‘gold standard’ for diagnosis of MI. We measured ST‐segment elevations in the 12‐, 16‐ and 24‐lead postadmission ECGs as well as in the 12‐, 19‐ and 24‐lead admission ECGs. Results: The sensitivity for detecting acute MI was 28% for the postadmission 12‐lead ECG, 33% for the 16‐lead ECG and 37% for the 24‐lead ECG. The specificities were 97%, 93% and 95%, respectively. For admission ECGs, the sensitivity was 33% for the 12‐lead ECG, 45% for the 19‐lead ECG and 49% for the 24‐lead ECG, with specificities of 97%, 96% and 94%, respectively. Conclusions: The sensitivity for detecting acute MI was higher for the 16‐, 19‐ and 24‐lead ECGs than for the conventional 12‐lead ECGs. Their specificity, however, was slightly lower. If increased sensitivity for detecting MI is desired, the 24‐lead or 19‐lead should be used as no additional electrodes are required.
Trägårdh et al. (Fri,) conducted a observational in Acute myocardial infarction (n=479). 16-lead, 19-lead, and 24-lead ECG vs. Conventional 12-lead ECG was evaluated on Sensitivity for detecting acute MI on admission ECG. The 24-lead and 19-lead admission ECGs increased sensitivity for detecting acute myocardial infarction to 49% and 45%, respectively, compared to 33% for the conventional 12-lead ECG.