Diagnosis of acute coronary occlusion using computed electrocardiographic imaging based on the 12-lead electrocardiogram, in comparison with ST- elevation myocardial infarction criteria

Introduction: Computed electrocardiographic imaging (CEI) is a method that uses ST- segment deviations from the 12-lead electrocardiogram (ECG) and has been tested on a small number of patients.Aim: To extend the testing material of the CEI method and deduce a threshold using ECGs recorded pre- and during acute occlusion. The performance of the CEI and ST elevation myocardial infarction (STEMI) criteria will be compared. Method: Two CEI images were generated from each of 99 patients before and during complete occlusion in the left anterior descending (LAD), right coronary artery (RCA) and left circumflex coronary artery (LCx). Result: The sensitivity and specificity of STEMI criteria was 61% and 96% respectively for the whole occlusion group. The sensitivities and specificities were 74 %, 97% (LAD); 60%, 94% (RCA); 35%, 100% (LCx) respectively, for STEMI criteria. A threshold of 998 units was deduced from the CEI method. Conclusion: The CEI method has similar diagnostic performance of an occlusion as STEMI criteria