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European Heart Journal 1997 18(8):1288-1295;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Vectorcardiographic monitoring of patients with acute myocardial infarction and chronic bundle branch block

P. Eriksson, K. Andersen, K. Swedberg and M. Dellborg

Clinical Experimental Research Laboratory, Department of Medicine, Östra University Hospital Göteborg, Sweden

Received 10 January 1997; accepted 28 January 1997.

Correspondence: Peter Eriksson MD, Department of Medicine, Östra University Hospital, 416 85 Göteborg, Sweden

Abstract

AIM: This study was set up to describe vectorcardiographic patterns in patients with bundle-branch block and acute myocardial infarction.

METHODS AND RESULTS: Sixty-five patients admitted to the coronary care unit with bundle-branch block and suspected acute myocardial infarction were monitored by dynamic vectorcardiography with trend analysis. In 28 patients, a clinical diagnosis of acute myocardial infarction was made. In patients with left bundle-branch block and acute myocardial infarction, the pattern of QRS vector-difference evolution was similar to that in patients with the narrow QRS complex, while ST vector-magnitude changes increased over time. Using a cut-off value for QRS vector-difference at 12 h of more than 20 µVs and a specific trend curve pattern, acute myocardial infarction in the presence of left bundle-branch block could be diagnosed with an accuracy of 71%. For patients with right bundle branch block, using a maximum ST vector-magnitude of >200 µV during the first 4 h, acute myocardial infarction could be diagnosed with a 78% accuracy.

CONCLUSION: Our results indicate that dynamic vectorcardiography is a valuable tool in diagnosing and monitoring acute myocardial infarction in patients with bundle branch block.

Key Words: Bundle branch block • acute myocardial infarction • vectorcardiography


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[Abstract] [Full Text] [PDF]


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