Diagnostic accuracy of a novel method for detection of acute transmural myocardial ischemia based upon a self-applicable 3-lead configuration

J Electrocardiol. 2016 Mar-Apr;49(2):192-201. doi: 10.1016/j.jelectrocard.2015.11.007. Epub 2015 Nov 23.

Abstract

Background: Delayed medical attendance is a leading cause of death in patients with ST elevation myocardial infarction (STEMI).

Methods: We aimed to introduce, develop, and validate a novel method (RELF method) for detection of transmural ischemia based on a new and easy-to-use 3-lead configuration and orthonormalization of ST reference vectors (STDVN). The study included 60 patients undergoing coronary artery occlusion (CAO) during balloon inflation and 30 healthy subjects.

Results: STDVN was significantly different and an optimal discriminator between CAO patients and healthy subjects (respectively 8.00±4.50 vs. 1.90±0.86 normalized units, p<0.001). Compared to the 12-lead ECG, the RELF method was sensitive (90 vs. 73%, p=0.13) and more specific (91 vs. 75%, p<0.001).

Conclusions: The RELF method is highly accurate for early detection of acute occlusion related ischemia and it outperforms the conventional 12-lead ECG criteria for STEMI. This method provides a platform for self-detection of CAO with handheld devices or smart phones.

Keywords: Diagnosis; Electrocardiography; Heart arrest; Myocardial infarction.

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Coronary Stenosis / complications
  • Coronary Stenosis / diagnosis*
  • Diagnosis, Computer-Assisted / instrumentation
  • Diagnosis, Computer-Assisted / methods*
  • Electrocardiography / instrumentation
  • Electrocardiography / methods*
  • Electrodes
  • Female
  • Humans
  • Male
  • Mobile Applications
  • Myocardial Ischemia / diagnosis*
  • Myocardial Ischemia / etiology
  • Reproducibility of Results
  • Self Care / instrumentation
  • Self Care / methods*
  • Sensitivity and Specificity
  • Telemedicine / instrumentation
  • Telemedicine / methods*