Implications of electrocardiogram in predicting the culprit artery in patients with inferior acute myocardial infarction

Objective:To assess the value of electrocardiogram in predicting the culprit artery in patients with inferior acute myocardial infarction(AMI).Method:Seventy-eight patients with inferior AMI underwent selective coronary were divided into two groups,right coronary artery(RCA) group and left circumflex coronary artery(LCX) group,according to the infarct-related artery.12-lead electrocardiograms were detected in two groups.Result:① The incidence of ST-segment depression ≥ 1mm in lead aVL was significantly higher in RCA group patients than that in LCX group patients(92% vs 24%,P0.01);② R/S ratio in lead aVL was significantly lower in RCA group patients than that in LCX group patients(2.7±0.4 vs 3.4±0.6,P0.01);③ The sensitivity,specificity,positive predictive values and negative predictive values of ST-segment depression ≥ 1 mm or R/S ratio ≤3 for predicting RCA culprit lesion were 92%,90%,96%,77% and 86%,95%,98%,70% respectively.Conclusion:The present study suggests that ST-segment depression or decreased R/S ratio during inferior AMI confers a greater likelihood of RCA disease.