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Electrocardiographic differentiation of early repolarization from subtle anterior ST-segment elevation myocardial infarction


Methodology Score: 3/5
Usefulness Score: 2/5

Smith SW, Khalil A, Henry TD, Rosas M, Chang RJ, Heller K, Scharrer E, Ghorashi M, Pearce LA

Ann Emerg Med. 2012 Jul;60(1):45-56.e2. Epub 2012 Apr 19.



This retrospective cohort study of anterior STEMI and Benign Early Repolarization (BER) patients derived and validated a mathematical combination of 3 ECG criteria (R-wave amplitude in lead V4, ST-segment elevation at 60 milliseconds after the J point in V3, and QTc) found sensitivity 86%, specificity 91%, and accuracy 88%.  The study was limited by spectrum bias, complex presentation of results, and a sensitivity similar to that of skilled clinicians. 
By: Dr. Kate Thompson

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