EBQ:Sgarbossa Criteria Study

incomplete Journal Club Article

Sgarbossa E. et al.. "Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators". NEJM. 1996. 334(8):481-7.
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Clinical Question

How can we Diagnose Acute Myocardial Infarction in Left Bundle Branch Block patients ?

Conclusion

A Validated Clinical prediction rule has been Developed based on ECG criteria to Diagnose Acute Myocardial infarction in Left Bundle Branch Patients

Major Points

1. ST-segment Elevation of at least 1 mm with concordance with the QRS complex
2. ST-segment depression in leads V1, V2 or V3
3. ST-segment Elevation of atleast 5 mm with discordance with the QRS complex

Population

Patient Demographics

• Median Age: 68 years
• Males: 64% in study group and 60% in experimental group
• Left Axis Deviation: 28% Vs. 48%
• Previous MI: 26% Vs. 59%

Inclusion Criteria

Patients with LBBB

Outcomes

Primary Outcome

Acute Myocardial Infarction

Funding

Grant from Bayer, Genentech, CIBA–Corning, ICI Pharmaceuticals, and Sanofi Pharmaceuticals.