Journal of Electrocardiology
Volume 43, Issue 3 , Pages 215-219, May 2010

Significance of a prominent Q wave in lead negative aVR (−aVR) in acute anterior myocardial infarction

  • Munenori Kotoku, MD

      Affiliations

    • Internal Medicine 2, Oita University, Yufu, Japan
    • ,
  • Akira Tamura, MD

      Affiliations

    • Internal Medicine 2, Oita University, Yufu, Japan
    • Corresponding Author InformationCorresponding author. Internal Medicine 2, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu 879-5593, Japan.
    • ,
  • Yusei Abe, MD

      Affiliations

    • Division of Cardiovascular Medicine, Almeida Memorial Hospital, Oita, Japan
    • ,
  • Junichi Kadota, MD, PhD

      Affiliations

    • Internal Medicine 2, Oita University, Yufu, Japan

Received 19 May 2009 published online 08 January 2010.

Abstract 

Purpose

The aim of this study was to clarify the significance of a Q wave in lead negative aVR (−aVR) in anterior wall acute myocardial infarction (AMI).

Methods

Eighty-seven patients with a first anterior wall AMI were classified into 2 groups according to the presence (n = 17, group A) or absence (n = 70, group B) of a prominent Q wave (duration ≥20 milliseconds) in lead −aVR at predischarge. Group A had a higher prevalence of a long left anterior descending coronary artery (LAD), a lower left ventricular ejection fraction, and more reduced regional wall motion in the apical and inferior regions than group B. None of group A patients had an LAD that did not reach the apex.

Conclusion

A prominent Q wave in lead −aVR in anterior wall AMI is related to severe regional wall motion abnormality in the apical and inferior regions, with an LAD wrapping around the apex.

Keywords: Acute myocardial infarction, Electrocardiography, Lead −aVR

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PII: S0022-0736(09)00623-2

doi:10.1016/j.jelectrocard.2009.12.004

Journal of Electrocardiology
Volume 43, Issue 3 , Pages 215-219, May 2010

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