A 12-lead ECG-method for quantifying ischemia-induced QRS prolongation to estimate the severity of the acute myocardial event

Abstract

Introduction: Studies have shown terminal QRS distortion and resultant QRS prolongation during ischemia to be a sign of low cardiac protection and thus a faster rate of myocardial cell death. A recent study introduced a single lead method to quantify the severity of ischemia by estimating QRS prolongation. This paper introduces a 12-lead method that, in contrast to the previous method, does not require access to a prior ECG.

Methods: QRS duration was estimated in the lead that showed the maximal ST deviation according to a novel method. The degree of prolongation was determined by subtracting the measured QRS duration in the lead that showed the least ST deviation.

Results: The method is demonstrated in examples of acute occlusion in two of the major coronary arteries.

Conclusion: This paper presents a 12-lead method to quantify the severity of ischemia, by measuring QRS prolongation, without requiring comparison with a previous ECG.

Keywords: Acute myocardial infarction; ECG; Electrocardiography; Ischemia; Severity of ischemia.