Simple, quantitative body surface potential map parameters in the diagnosis of remote Q wave and non-Q wave myocardial infarction

Mihály Medvegy, Pierre Savard, Arnold Pintér, Gaétan Tremblay, James B. Nasmith, Donald Palisaitis, Gábor Duray, István Préda, Réginald A. Nadeau

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Body surface potential mapping has been shown to be a useful tool in the diagnosis and localization of remote non-Q wave and Q wave myocardial infarction, but human expertise is required to interpret the maps. Objective: To identify quantitative body surface potential mapping parameters that could enable a computer-based diagnosis. Methods: Body surface isopotential maps (63 unipolar leads) were recorded in 86 patients with remote Q wave and 71 patients with remote non-Q wave myocardial infarction. Twenty-four healthy adults served as control subjects. Myocardial infarctions were classified using standard electrocardiogram leads in the acute and chronic phases, and were validated by coronary angiography, ventriculography and thallium scintigraphy. Results: Two simple quantitative parameters with high diagnostic power were identified: the time interval between the peak minimum and the peak maximum potentials (time-shift), and the ratio of these potentials (maximum to minimum ratio [max/min]). Both parameters showed significant differences between infarction patients and normal control subjects, and optimum cut-off values were determined using receiver operating characteristic curves (anterior infarction: time-shift of -4 ins or less, max/min of 0.6 or less; posterior infarction: time-shift of 8 ins or greater, max/min of 1.25 or greater). The sensitivities of the two parameters were 100% and 97%, and the specificities were 99% and 100%, respectively, in the anterior Q wave infarction group, compared with sensitivities of 88% and 100%, and specificities of 94% and 95%, respectively, in the posterior Q wave infarction group. In the anterior non-Q wave infarction group, sensitivity was 35% for both parameters, specificity was 100% for both parameters, and only infarctions associated with a low ejection fraction were detected, indicating that infarction size may influence the power of the tests. Conclusions: Time-shift and max/min are two new, simple, powerful parameters for infarction diagnosis and may also be suitable for automated, computer-based processing.

Original languageEnglish
Pages (from-to)1109-1115
Number of pages7
JournalCanadian Journal of Cardiology
Volume20
Issue number11
Publication statusPublished - Sep 1 2004

Keywords

  • Diagnosis testing
  • Electrocardiology
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Medvegy, M., Savard, P., Pintér, A., Tremblay, G., Nasmith, J. B., Palisaitis, D., Duray, G., Préda, I., & Nadeau, R. A. (2004). Simple, quantitative body surface potential map parameters in the diagnosis of remote Q wave and non-Q wave myocardial infarction. Canadian Journal of Cardiology, 20(11), 1109-1115.