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MI Diagnosis in LBBB or paced rhythm

431 bytes added, 14:21, 28 February 2011
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At a score-sum of 3, these criteria have a specificity of 90% for detecting a myocardial infarction.
During right ventricular pacing the ECG also shows left bundle brach block and the above rules also apply for the diagnosis of myocardial infarction during pacing, however they are less specific.<cite>3</cite><cite>4</cite>In the GUSTO-1 trial the ECG criterion with a high specificity and statistical significance for the diagnosis of an acute MI was:* ST segment elevation ≥5 mm in leads with a negative QRS complex <cite>Gusto</cite>. Two other criteria with acceptable specificity were:*ST elevation ≥1 mm in leads with concordant QRS polarity*ST depression ≥1 mm in leads V1, V2, or, V3
#3 pmid=18651461
#4 pmid=15127382
#Gusto pmid=8602576

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