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Volume 42, Issue 2, Pages 145-151 (March 2009)


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EASI-Derived vs standard 12-lead electrocardiogram for Selvester QRS score estimations of chronic myocardial infarct size, using cardiac magnetic resonance imaging as gold standard

Annika E. Welinder, MDaCorresponding Author Informationemail address, Galen S. Wagner, MDb, B. Milan Horáček, PhDc, Thomas N. Martin, MDd, Charles Maynard, PhDe, Olle Pahlm, MD, PhDa

Received 4 September 2008 published online 19 December 2008.

Abstract 

Background

The size of myocardial infarction (MI) is of significance for the prognosis. Selvester scores might be valuable for this estimation.

Objective

To compare the differences in Selvester scores for chronic MI provided from standard and EASI-derived 12-lead electrocardiograms (ECGs) and to compare these scores to the MI size measured by delayed-enhancement magnetic resonance imaging (DE-MRI).

Methods

Thirty-seven patients were studied. In connection with their DE-MRI scan follow-up after chest pain, body surface potential mapping was performed. Standard and EASI 12-lead ECGs were constructed from the maps. Two investigators manually performed the measurements required for scoring with the Selvester system using a quad-plot format of the ECGs. One of the investigators repeated this once for the standard leads.

Results

The differences between the 2 ECG estimations of MRI-measured MI size were not statistically significant. Neither the association nor the agreement between MRI and EASI-lead measurements or between MRI and standard-lead measurements were very strong.

Conclusions

The differences between ECG and MRI measurements of MI size indicate that both methods may need improvement.

a Department of Clinical Physiology, University Hospital, Lund, Sweden

b Duke University Medical Center, Durham, NC

c Faculty of Medicine of Dalhousie University, Halifax, Nova Scotia, Canada

d Department of Cardiology, Western Infirmary, Glasgow, Scotland, UK

e Department of Health Services, University of Washington, Seattle, WA

Corresponding Author InformationCorresponding author. Department of Clinical Physiology, Lund University Hospital, SE-221 85 Lund, Sweden. Tel.: +46 46 17 33 07; fax: +46 46 15 17 69.

 This study was supported in part by the Region of Scania, Kristianstad, Sweden.

PII: S0022-0736(08)00441-X

doi:10.1016/j.jelectrocard.2008.10.010


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