Value of premature ventricular contraction morphology in the detection of myocardial infarction

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Updated: Aug 17, 2026

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

S B Lichtenberg, M J Schwartz, R B Case

    Journal of Electrocardiology
    |April 1, 1980
    PubMed

    Insights

    A QR pattern ventricular premature contraction (VPC) can indicate anterior myocardial infarction. This study found specific QR VPC criteria in lead V1 offer high specificity for detecting anterior heart attacks.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Diagnostic Imaging

    Background:

    • Ventricular premature contractions (VPCs) with a QR pattern are linked to myocardial infarction.
    • The diagnostic accuracy of QR VPCs for identifying infarction requires further validation.

    Purpose of the Study:

    • To assess the validity of QR pattern VPCs as an indicator of localized myocardial infarction.
    • To compare VPC morphology with left ventricular wall motion abnormalities.

    Main Methods:

    • Induction of VPCs via catheter stimulation of the left ventricular endocardium.
    • Comparison of VPC morphology (V1, aVF leads) with left ventricular angiography findings.
    • Evaluation of specificity, sensitivity, and predictive value of QR VPCs for anterior and inferior myocardial infarction.

    Main Results:

    • A QR pattern VPC in lead V1 (Q ≥ 0.04 sec, Q/R ratio = 0.20) showed 93% specificity, 24% sensitivity, and 72% predictive value for anterior myocardial infarction.
    • Increasing sensitivity for anterior infarction detection (up to 0.87 specificity) was observed with a Q/R ratio ≥ 0.1.
    • Detection of inferior infarction using aVF lead VPCs was less reliable.

    Conclusions:

    • Specific QR pattern VPCs in lead V1 are a valuable, highly specific indicator for detecting anterior myocardial infarction.
    • The utility of aVF lead VPCs for detecting inferior myocardial infarction is limited.

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