Electrocardiographic criteria for predicting the culprit artety in inferior wall acute myocardial infarction

Objective The purpose of this study is to investigate the electrocardiographic criteria for predicting the culprit aitery in inferior wall acute myocardial infarction (AMI). Methods According to the features of electro- cardiogram (ECG)in lead aVL, patients were divided into Pattern I (S/R≤1/3, ST-segment depression≤1mm) and Pattern Ⅱ (S/R 1/3, ST-segment depression 1mm), infarction related arteries (IRA) were divided into entities of right coronary artery (RCA) (35 cases)or left circumflex artery (LCX) (16 cases)confirmed by coronary arteriography in 51 patients with inferior wall AMI. Results The incidence of Pattern Ⅱ was higher in RCA group than that in LCX group (P 0.05), with the sensitivity and specificity of 77.1% and 81.3% respectively in predicting occlusion of RCA. The incidence of Pattern I was higher in LCX group than that in RCA group (P 0.05) with the sensitivity and specificity of 81.3% and 77.1% respectively in predicting occlusion of LCX. Condusion Pattern I of the QRS complex in lead aVL is a sensitive and specific marker for LCX artery occlusion, whereas pattern Ⅱ suggests RCA related AMI diseases.