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{
    "pk": 17642,
    "title": "Sgarbossa Criteria are Highly Specific for Acute Myocardial Infarction with Pacemakers",
    "subtitle": null,
    "abstract": "Objective: In 1996 Sgarbossa reviewed 17 ventricular-paced electrocardiograms (ECGs) in acute myocardial infarction (AMI) for signs of ischemia. Several characteristics of the paced ECG were predictive of AMI. We sought to evaluate the criteria in ventricular-paced ECGs in an emergency department (ED) cohort.\n\n\nMethods: Ventricular-paced ECGs in patients with elevated cardiac markers within 12 hours of the ED ECG and a diagnosis of AMI were identified retrospectively (n=57) and compared with a control group of patients with ventricular-paced ECGs and negative cardiac markers (n=99). A blinded board certified cardiologist reviewed all ECGs for Sgarbossa criteria. This study was approved by the institutional review board.\n\n\nResults: Application of Sgarbossa’s criteria to the paced ECGs revealed the following:  1) The sensitivity of “ST-segment elevation of 1 mm concordant with the QRS complex” was unable to be calculated as no ECG fit this criterion;  2) For “ST-segment depression of 1 mm in lead V1, V2, or V3,” the sensitivity was 19% (95% CI 11-31%), specificity 81% (95% CI 72-87%), with a likelihood ratio of 1.06 (0.63-1.64);  3) For “ST-segment elevation >5mm discordant with the QRS complex,” the sensitivity was 10% (95% CI 5-21%), specificity 99% (95% CI 93-99%), with a likelihood ratio of 5.2 (1.3 - 21).\n\n\nConclusion: In our review of ventricular-paced ECGs, the most clinically useful Sgarbossa criterion in identifying AMI was ST-segment elevation >5mm discordant with the QRS complex. This characteristic may prove helpful in identifying patients who may ultimately benefit from early aggressive AMI treatment strategies. [West J Emerg Med. 2010; 11(4):354-357.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "acute myocardial infarction"
        },
        {
            "word": "Ventricular Pacemaker"
        },
        {
            "word": "electrocardiogram"
        },
        {
            "word": "cardiology"
        },
        {
            "word": "Emergency Medicine"
        }
    ],
    "section": "Article",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/36q1s5tr",
    "frozenauthors": [
        {
            "first_name": "Kevin",
            "middle_name": "R",
            "last_name": "Maloy",
            "name_suffix": "",
            "institution": "Washington Hospital Center and Georgetown University Hospital, Department of Emergency Medicine",
            "department": "None"
        },
        {
            "first_name": "Rahul",
            "middle_name": "",
            "last_name": "Bhat",
            "name_suffix": "",
            "institution": "Washington Hospital Center and Georgetown University Hospital, Department of Emergency Medicine",
            "department": "None"
        },
        {
            "first_name": "Richard",
            "middle_name": "",
            "last_name": "Morrissey",
            "name_suffix": "",
            "institution": "Washington Hospital Center and Georgetown University Hospital, Department of Emergency Medicine",
            "department": "None"
        },
        {
            "first_name": "Jonathan",
            "middle_name": "",
            "last_name": "Davis",
            "name_suffix": "",
            "institution": "Washington Hospital Center and Georgetown University Hospital, Department of Emergency Medicine",
            "department": "None"
        },
        {
            "first_name": "Kevin",
            "middle_name": "",
            "last_name": "Reed",
            "name_suffix": "",
            "institution": "Georgetown University Hospital, Division of Cardiology, Department of Medicine",
            "department": "None"
        }
    ],
    "date_submitted": "2009-02-20T08:00:00Z",
    "date_accepted": "2009-02-20T08:00:00Z",
    "date_published": "2010-09-24T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/17642/galley/9005/download/"
        }
    ]
}