Sgarbossa et al reported criteria for acute myocardial infarction in the presence of ventricular paced rhythm. These are similar to the criteria for a patient with left bundle branch block. The authors are GUSTO-1 (Global Utilization of Streptokinase and Tissue plasminogen activator for Occluded coronary arteries) investigators.
Patient selection: ventricular paced rhythm (VPR)
ECG criteria:
(1) ST segment elevation >= 1 mm in leads with a positive QRS complex
(2) ST segment depression >= 1 mm in leads V1, V2 or V3
(3) ST segment elevation >= 5 mm in leads with a negative QRS complex
Parameter
Finding
Points
criterion 1
absent
0
present
5
criterion 2
absent
0
present
3
criterion 3
absent
0
present
2
score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the risk of having an acute myocardial infarction.
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