The diagnosis of myocardial infarction (MI) in the presence of left bundle branch
block (LBBB) has long been considered problematic or even almost impossible. Many
proposed ECG markers in the old literature have now been discarded. However, the advent
of reperfusion therapy has generated greater interest in the ECG diagnosis of acute
MI (based on ST-segment abnormalities) [
1
,
2
,
3
,
4
], although criteria for old MI (based on QRS changes) have not been reevaluated for
almost 20 years [
5
,
6
]. Furthermore, analysis of the some of the published data is compounded by the considerable
interobserver variability in the interpretation of ECGs [
6
,
7
,
8
].To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.
Content published before 2002 is available via pay-per-view purchase only.
Subscribe:
Subscribe to Cardiology ClinicsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle branch block.New Engl J Med. 1996; 334: 481-487
- Recent advances in the electrocardiographic diagnosis of myocardial infarction: left bundle branch block and pacing.Pacing Clin Electrophysiol. 1996; 19: 1370-1379
- Value of the ECG in suspected acute myocardial infarction with left bundle branch block.J Electrocardiol. 2000; 33: 87-92
- Patients with prolonged ischemic chest pain and presumed-new left bundle branch block have heterogeneous outcomes depending on the presence of ST-segmentchanges.J Am Coll Cardiol. 2005; 46: 29-38
- Electrocardiographic diagnosis of myocardial infarction in the presence of complete left bundle branch block.Am Heart J. 1988; 116: 23-32
- The diagnosis of myocardial infarction in the presence of left bundle branch block.Cardiol Clin. 1987; 5: 393-401
- Acute myocardial infarction and left bundle-branch block—can we lift the veil?.N Engl J Med. 1996; 334: 528-529
- Diagnosing acute myocardial infarction in the setting of left bundle branch block: prevalence and observer variability from a large community setting.Coronary Artery Dis. 2003; 14: 387-393
- Myocardial infarction complicated by left bundle branch block.Am Heart J. 1956; 51: 78-90
- Complete left bundle branch block: is the diagnosis of myocardial infarction possible?.Int J Cardiol. 1983; 2: 521-529
- Ischemic blocks during early phase of anterior myocardial infarction: correlation with ST-segment shift.Clin Cardiol. 1988; 11: 757-762
- ST-segment changes during transmural myocardial ischemia in chronic left bundle branch block.Am J Cardiol. 1989; 64: 1216-1217
- Quantification of ST-segment changes during coronary angioplasty in patients with left bundle branch block.Am J Cardiol. 1991; 67: 1219-1222
- A critique of the new ST-segment criteria for the diagnosis of acute myocardial infarction in patients with left bundle-branch block.Clin Cardiol. 2001; 24: 652-655
- ST-segment elevation in leads V1–V3 in patients with LBBB.J Electrocardiol. 2001; 34: 87-88
- Electrocardiographic diagnosis of myocardial infarction in patients with left bundle branch block.Ann Emerg Med. 2000; 36: 561-565
- Interobserver variability in the electrocardiographic diagnosis of acute myocardial infarction in patients with left bundle branch block.Ann Emerg Med. 2000; 36: 566-571
- ECG criteria in diagnosis of acute myocardial infarction in the presence of left bundle branch block.Int J Cardiol. 2001; 78: 167-174
- Can myocardial infarction be rapidly identified in Emergency Department patients who have left bundle branch block?.Ann Emerg Med. 2001; 37: 431-438
- Should the electrocardiogram be used to guide therapy for patients with left bundle-branch block and suspected myocardial infarction?.JAMA. 1999; 281: 714-719
- Suspected myocardial infarction and left bundle branch block: electrocardiographic indicators of acute ischaemia.J Accid Emerg Med. 1999; 16: 331-335
- Comorbidity and myocardial dysfunction are the main explanations for the higher 1-year mortality in acute myocardial infarction with left bundle-branch block.Circulation. 2004; 110: 1896-1902
- Left bundle branch block in acute myocardial infarction: benign or malignant?.J Am Coll Cardiol. 2005; 46: 39-41
- Implications of left bundle branch block in acute myocardial infarction treated with primary angioplasty.Am J Cardiol. 2002; 90: 401-403
- Indications for fibrinolytic therapy in suspected myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients.Lancet. 1994; 343: 311-322
- ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction; a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction).J Am Coll Cardiol. 2004; 44: E1-211
- Electrocardiographic diagnosis of myocardial infarction in cases of complete left bundle branch block.Am Heart J. 1960; 60: 886-897
- A vectorcardiographic and electrocardiographic study of left bundle branch block with myocardial infarction.Am J Cardiol. 1966; 17: 171-179
- La onda de activación ventricular en el bloqueo de rama izquierda con infarto: un nuevo signo electrocardiográfico.Arch Inst Cardiol Mex. 1953; 23: 441-460
- A case of myocardial infarction masked by bundle branch block but revealed by occasional premature ventricular beats.Am J Med Sci. 1943; 206: 361
- Diagnostic significance of the QRS wave form in patients with ventricular tachycardia.Cardiol Clin. 1987; 5: 527-540
- Endocardial and epicardial recordings. Correlation of twelve-lead electrocardiograms at the site of origin of ventricular tachycardia.Ann N Y Acad Sci. 1990; 601: 128-147
Article info
Identification
Copyright
© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
