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[Diagnosis of myocardial infarction in patients with cardiac pacing]

Myriam Kaddour1, Haran Burri2

  • 1Service de médecine interne générale, HUG, 1211 Genève 14.

Revue Medicale Suisse
|May 26, 2018
PubMed

Insights

Diagnosing acute coronary syndrome is challenging in patients with cardiac pacing due to altered electrocardiogram (ECG) criteria. This review covers ECG changes and cardiac memory to prevent misdiagnosis of myocardial ischemia.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Cardiac Electrophysiology

Context:

  • Acute coronary syndrome (ACS) diagnosis is complicated in patients with cardiac pacing.
  • Standard ECG criteria for ischemia are unreliable with ventricular paced rhythms.
  • Previous myocardial infarction further complicates ECG interpretation.

Purpose:

  • To review ECG modifications in patients with cardiac pacing and prior myocardial infarction.
  • To discuss the phenomenon of cardiac memory and its impact on ischemia diagnosis.
  • To provide guidance for accurate ACS diagnosis in paced rhythms.

Summary:

  • This article examines ECG changes in patients with cardiac pacing, particularly ventricular pacing.
  • It addresses the diagnostic challenges posed by previous myocardial infarction.
  • The role of cardiac memory in potentially causing false-positive ischemia diagnoses is explored.

Impact:

  • Improved diagnostic accuracy for acute coronary syndrome in patients with cardiac pacing.
  • Reduced misdiagnosis of myocardial ischemia due to paced rhythms and cardiac memory.
  • Enhanced clinical decision-making for cardiologists managing these complex cases.

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