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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Prognostic implications of PR-segment depression in inferior leads in acute inferior myocardial infarction

Man-Hong Jim1, Chung-Wah Siu, Annie On-on Chan

  • 1Department of Medicine, Queen Mary Hospital, Hong Kong, PRC. jimmanh2002@yahoo.com

Clinical Cardiology
|August 29, 2006
PubMed

Insights

PR-segment depression in inferior leads, an electrocardiogram (ECG) sign, indicates concurrent atrial ischemia in acute myocardial infarction (MI). This finding is linked to higher risks of complications and in-hospital mortality.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • Concurrent atrial ischemia is often missed in acute myocardial infarction (MI) due to subtle electrocardiogram (ECG) findings and unclear clinical presentation.
  • PR-segment depression in inferior leads is a potential ECG indicator of atrial ischemia.

Purpose of the Study:

  • To determine the incidence, clinical features, and prognostic significance of PR-segment depression in the inferior leads during acute inferior MI.
  • To evaluate the association between this ECG sign and adverse outcomes in acute MI patients.

Main Methods:

  • Retrospective review of 463 patients with acute inferior MI.
  • Analysis of in-hospital ECGs by two independent reviewers to identify PR-segment depression (> or = 1.2 mm in inferior leads).
  • Comparison of clinical characteristics and outcomes between patients with and without the identified ECG sign.

Main Results:

  • PR-segment depression was observed in 1.9% of patients with acute inferior MI.
  • Patients with this sign presented earlier and had higher rates of first-degree atrioventricular block and supraventricular arrhythmias.
  • A significant association was found between PR-segment depression and increased cardiac free-wall rupture and in-hospital mortality.

Conclusions:

  • Profound PR-segment depression in inferior leads signifies a higher risk of complications and poor short-term outcomes in acute inferior MI.
  • Patients exhibiting this ECG sign require close monitoring for atrioventricular block, supraventricular arrhythmias, and cardiac free-wall rupture.
Abstract

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