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      False-Negative and False-Positive ECG Diagnoses of Q Wave Myocardial Infarction in the Presence of Right Bundle-Branch Block

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          Abstract

          Right bundle-branch block (RBBB) has not traditionally been seen as an obstacle to ECG diagnosis of Q wave myocardial infarction (MI) – in clinical electrocardiography and vectorcardiography – because this conduction disturbance is not believed to cause significant alterations in the spatial orientation of initial excitation wavefronts. In the era of large-scale clinical trials, however, where serial ECG analysis is among the major diagnostic tools in MI classification, both false-positive and false-negative diagnoses of MI in the presence of RBBB have become increasingly evident. Because of the limited detectability of Q wave MI by ECG in the presence of RBBB, the electrocardiographic finding of Q wave MI should not be regarded as an independent diagnostic tool. It is best to utilize independent corroboration to establish the diagnosis of transmural infarction when RBBB is present. Further investigations are warranted to better delineate sensitivity, specificity, and predictive value of Q wave MI in the presence of RBBB.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          2000
          February 2001
          02 March 2001
          : 94
          : 3
          : 165-172
          Affiliations
          aMayo Physician Alliance for Clinical Trials, Rochester, Minn., bDivision of Cardiology, St. Louis University Health Science Center, St. Louis, Mo., cCardiology Products Division, Hewlett-Packard, Andover, Mass., and dDivision of Cardiovascular Diseases and Internal Medicine, Rochester, Minn., USA
          Article
          47312 Cardiology 2000;94:165–172
          10.1159/000047312
          11279322
          © 2001 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 6, References: 36, Pages: 8
          Categories
          Arrhythmias, Electrophysiology and Electrocardiography

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