A proposed classification of changes in the electrocardiogram in acute myocardial infarction

Concepts regarding the aetiology and significance of changes in the electrocardiogram in acute myocardial infarction (AMI) have been changing and modified substantially in recent years. Today, the electrocardiogram must be analysed in the light of our current knowledge. When interpreting it, one must consider all the new information that electrocardiography (including electrical field monitoring by means of body surface mapping) employing sophisticated technology can provide. Optimal electrocardiographic information and its classification in AMI require detailed evaluation of the electrocardiogram characterizing all alterations in waves, ST segment denivelizations as well as their combinations, distribution and duration. The authors propose a new classification of alterations in the electrocardiogram in AMI which takes into account also the dynamics of electrocardiographic alterations, formerly a standard parameter. Future research and, most importantly, clinical practice will show whether this electrocardiographic classification allows identification of relatively homogeneous (in terms of clinical status and prognosis) groups of patients with AMI.