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Recording lead V(4)R is associated to enhanced use of fibrinolytic therapy in acute myocardial infarction.
- Source :
-
Journal of electrocardiology [J Electrocardiol] 2006 Oct; Vol. 39 (4), pp. 368.e1-5. Date of Electronic Publication: 2006 May 12. - Publication Year :
- 2006
-
Abstract
- Background: ST-segment elevation in the right-sided chest lead V(4)R in inferior wall myocardial infarction is recognized as a sign of proximal occlusion of the right coronary artery with evolving right ventricular myocardial infarction. Our objective is to study how often lead V(4)R is recorded in clinical practice and how this might be associated with use of reperfusion therapy and outcome of patients.<br />Methods: Recording of lead V(4)R in 814 consecutive patients with acute myocardial infarction, administration of therapy, and outcome of the patients during a median follow-up of 285 days (174-313 days) were studied.<br />Results: V(4)R was recorded in 52% of patients with inferior ST-elevation myocardial infarction. Patients with V(4)R recorded were more likely to receive fibrinolytic therapy compared with patients without recording (65% vs 51%; P = .035). In multivariate analysis, recording of lead V(4)R (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.1-2.2; P = .006), along with age (P < .001), previous myocardial infarction (OR 2.2, 95% CI 1.3-3.5; P = .002), and diabetes (OR 3.9, 95% CI 1.1-2.4; P = .03) correlated to the use of reperfusion therapy. Patients with lead V(4)R recorded had less (P = .055) reinfarction, unstable angina, stroke, and/or death during follow-up.<br />Conclusions: Lead V(4)R was recorded in only half of patients with inferior ST-elevation myocardial infarction. Patients with V(4)R recorded were more likely to receive thrombolytic therapy than those without recording of the additional chest lead.
- Subjects :
- Aged
Female
Finland epidemiology
Humans
Male
Myocardial Infarction mortality
Reproducibility of Results
Risk Factors
Sensitivity and Specificity
Survival Rate
Thrombolytic Therapy methods
Treatment Outcome
Electrocardiography methods
Electrocardiography statistics & numerical data
Fibrinolytic Agents therapeutic use
Myocardial Infarction diagnosis
Myocardial Infarction drug therapy
Risk Assessment methods
Thrombolytic Therapy statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8430
- Volume :
- 39
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of electrocardiology
- Publication Type :
- Academic Journal
- Accession number :
- 16697401
- Full Text :
- https://doi.org/10.1016/j.jelectrocard.2006.03.005