Use of an 80-lead Body Map to Detect Acute ST-Elevation ...
USE OF AN 80-LEAD BODY MAP TO DETECT ACUTE ST-ELEVATION MYOCARDIAL INFARCTION
J.P. Ornato
Virginia Commonwealth University, Richmond, Virginia
Conventional 12-lead electrocardiography (ECG) is limited in its ability to detect myocardial infarction in the lateral, posterior, and right ventricular locations. We conducted a multicenter, randomized clinical trial to determine whether an 80-lead body map system (MAP) could detect more acute ST-segment elevation MIs (STEMI) than standard 12-lead ECGs (ECG) in chest pain pts presenting to 4 hospital EDs. A trained technician performed a ECG and MAP on all consenting adult ED chest pain pts. Sensitivity and specificity of each test for detecting STEMI was calculated using 3 different definitions, all of which required diagnostic ST elevation on either ECG or MAP plus: 1) elevated CKMB (CKMB-MI); or 2) elevated troponin (TROP-MI). Results were as follows:
Sensitivity Specificity
| |N |ECG |MAP |ECG |MAP |
|CKMB-MI |22/365 |72.7% |100% |96.7% |96.0% |
|TROP-MI |28/225 |60.7% |93.3% |95.2% |93.2% |
Posterior MI locations most commonly missed by ECG but detected by MAP. In addition, we have also begun to use the MAP in the cardiac catheterization laboratory during elective coronary angioplasty. Preliminary results suggest that it is not only possible to detect the myocardial injury, but to localize the coronary obstruction by vessel.
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