ECG evaluation in patients with pacemaker and suspected acute coronary syndrome: Which score should we apply?

Freitas, P; Santos, Mónica; Faria, Mariana de Gregório; Rodrigues, G; Vale, Nélson; Teles, Rui Campante; Almeida, Manuel; Mendes, Miguel

doi:10.1016/j.jelectrocard.2016.06.012

Cited by 9 publications

(4 citation statements)

References 14 publications

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“…Since the surface ECG is the summation of cellular depolarization and conduction, it is not surprising that the ECG may be inadequate at determining small variations in lead tip position. This study emphasizes the complexity of depolarization within a diseased heart and may also partially explain the difficulties in determining ECG changes during ischemia and acute infarction in paced patients …”

Section: Discussionmentioning

confidence: 81%

“…This study emphasizes the complexity of depolarization within a diseased heart and may also partially explain the difficulties in determining ECG changes during ischemia and acute infarction in paced patients. 20 The best way to achieve consistent RVS lead implantation is currently unknown and better tools may need to be developed if this is still believed to be a superior site for pacing. We believe that CT localization of lead position is a valuable research tool when looking at RVNA pacing and perhaps should be considered the "gold standard" for imaging pacing lead tip position.…”

Section: Discussionmentioning

confidence: 99%

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Surface ECG and Fluoroscopy are Not Predictive of Right Ventricular Septal Lead Position Compared to Cardiac CT

Rowe

Moore

Pratap

et al. 2017

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Surface ECG and Fluoroscopy are Not Predictive of Right Ventricular Septal Lead Position Compared to Cardiac CT

Rowe

Moore

Pratap

et al. 2017

Pacing Clinical Electrophis

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“…The third component of the Sgarbossa criteria was substituted with the Selvester or Smith rules. This study found the Selvester criteria to have the best sensitivity of the three while the most specific was Sgarbossa's [30], and the most accurate was the Smith criteria (Table 7).…”

Section: Right Ventricular Pacingmentioning

confidence: 76%

Diagnosis of Occlusion Myocardial Infarction in Patients with Left Bundle Branch Block and Paced Rhythms

et al. 2021

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Purpose of Review A number of criteria have been developed to aid with the diagnosis of occlusion myocardial infarction (OMI) in patients with left bundle branch block (LBBB) and ventricular paced rhythms (VPR). The current guidelines do not provide clear preference for any specific ECG criteria in LBBB and paced rhythm patients. Recent Findings This review delineates the difficulties of electrocardiographic diagnosis of OMI in both LBBB and VPR patients. We describe the original Sgarbossa and the newer criteria and their diagnostic performances. We highlight the expected changes of newer pacing modalities and how they may interfere with the electrocardiographic diagnosis of OMI. Summary We recommend utilizing the Cai et al. algorithm, which combines clinical assessment with the Smith Modified Sgarbossa ECG criteria, for both LBBB and right ventricular pacing patients with suspected OMI. There is limited data concerning ECG changes of OMI in patients with the newer pacing modalities, such as biventricular, His-bundle, or left bundle branch pacing. KeywordsOcclusion myocardial infarction • Sgarbossa criteria • Smith-modified Sgarbossa criteria • Right ventricular pacing • ST-elevation myocardial infarction • Left bundle branch block This article is part of the Topical Collection on Management of Acute Coronary Syndromes

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“…Fordyce et al 6 only included patients with confirmed acute coronary syndrome (ACS) precluding calculation of specificity and positive predictive value. In the only work to have directly answered this question, Freitas et al 7 included 43 patients with ventricular paced rhythm (VPR) of whom 60% had STEMI. This study demonstrated that the original Sgarbossa criteria had 100% specificity and positive predictive value, and are therefore useful to ‘rule in’ ACO.…”

Section: Commentsmentioning

confidence: 99%

BET 2: Diagnosing acute myocardial infarction in the presence of ventricular pacing: can Sgarbossa criteria help?

Jothieswaran

Body

2016

Emerg Med J

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The Sgarbossa criteria can be used to identify patients who have acute myocardial infarction (AMI) in the presence of left bundle branch block, which obscures the usual changes associated with ST elevation myocardial infarction. Patients with ventricular paced rhythm have ECG changes with similar morphology to left bundle branch block. A short-cut systematic review was carried out to establish whether the Sgarbossa criteria can accurately diagnose AMI in the presence of ventricular paced rhythm. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that.

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ECG evaluation in patients with pacemaker and suspected acute coronary syndrome: Which score should we apply?

Cited by 9 publications

References 14 publications

Surface ECG and Fluoroscopy are Not Predictive of Right Ventricular Septal Lead Position Compared to Cardiac CT

Surface ECG and Fluoroscopy are Not Predictive of Right Ventricular Septal Lead Position Compared to Cardiac CT

Diagnosis of Occlusion Myocardial Infarction in Patients with Left Bundle Branch Block and Paced Rhythms

BET 2: Diagnosing acute myocardial infarction in the presence of ventricular pacing: can Sgarbossa criteria help?

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