A statistical analysis of the ECG measurements used in computerized interpretation of acute anterior myocardial infarction with applications to interpretive criteria development.

Computerized interpretation of the electrocardiogram (ECG) for detection of acute myocardial infarction (AMI) has been an area of active investigation for the past few years. Advances in the development of criteria for increased accuracy have resulted through the use of clinically correlated databases. Previously, using such databases, the sensitivity for interpretation of AMI in the Marquette 12SL ECG analysis program has increased from 21% to 65% with specificity remaining unchanged (99%). This study attempted to find measurements of the QRS and ST-segment from 7 of the 12 standard ECG leads to increase the sensitivity of detection of anterior AMI to the level of a trained physician while maintaining the current level of specificity. Regression analyses were performed on the measurements to see which ones could improve sensitivity and what effect they had on specificity. There was no clear separation of the individual measurements between the normal database or the true positive and true negative anterior AMI databases for maintaining high specificity. In a parallel study of the same data, deterministic criteria combining both ST and T wave information increased the sensitivity of the 12SL analysis program for detection of anterior AMI to 71% on a clinically correlated anterior AMI database and 75% on a physician interpreted anterior AMI database while maintaining the specificity at 99%.