P. Eriksson et al., VECTORCARDIOGRAPHIC MONITORING OF PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION AND CHRONIC BUNDLE-BRANCH BLOCK, European heart journal, 18(8), 1997, pp. 1288-1295
Aims This study was set up to describe vectorcardiographic patterns in
patients with bundle-branch block and acute myocardial infarction. Me
thods and Results Sixty-five patients admitted to the coronary care un
it with bundle-branch block and suspected acute myocardial infarction
were monitored by dynamic vectorcardiography with trend analysis. In 2
8 patients, a clinical diagnosis of acute myocardial infarction was ma
de. In patients with left bundle-branch block and acute myocardial inf
arction, the pattern of QRS vector-difference evolution was similar to
that in patients with the narrow QRS complex, while ST vector-magnitu
de changes increased over time. Using a cut-off value for QRS vector-d
ifference at 12 h of more than 20 mu Vs and a specific trend curve pat
tern, acute myocardial infarction in the presence of left bundle-branc
h block could be diagnosed with an accuracy of 71%. For patients with
right bundle branch block, using a maximum ST vector-magnitude of >200
mu V during the first 4 h, acute myocardial infarction could be diagn
osed with a 78% accuracy. Conclusion Our results indicate that dynamic
vectorcardiography is a valuable tool in diagnosing and monitoring ac
ute myocardiai infarction in patients with bundle branch block.