Improved ECG interpretation using synthesized VCG for the diagnosis of inferior myocardial infarction

Electrocardiographic (ECG) criteria for the diagnosis of inferior myocardial infarction (IMI) have high specificity but low sensitivity. Vectorcardiographic IMI criteria attain higher sensitivity without sacrificing specificity. One approach to improving ECG interpretation is to synthesize VCG loops from the 12-lead ECG. The performance of synthesized VCG (SVCG) was assessed, using the Frank VCG criterion of Starr et al. ECGs and SVCGs from 351 normal subjects and 65 patients with IMI verified by myocardial scintigraphy or angiocardiography were studied. The sensitivity was 14 percentage points higher for SVCG than for ECG (72% vs. 58%).