Annals of Emergency Medicine
Volume 54, Issue 6 , Pages 779-788.e1 , December 2009

Acute Detection of ST-Elevation Myocardial Infarction Missed on Standard 12-Lead ECG With a Novel 80-Lead Real-Time Digital Body Surface Map: Primary Results From the Multicenter OCCULT MI Trial

  • James W. Hoekstra, MD

      Affiliations

    • Wake Forest University, Winston-Salem, NC
    • Corresponding Author InformationAddress for correspondence: James Hoekstra, MD, Department of Emergency Medicine, Wake Forest University Health Sciences, Medical Center Blvd, Winston-Salem, NC 27023; 336-716-4626, fax 336-716-5438
    • ,
  • Brian J. O'Neill, MD

      Affiliations

    • Wayne State University, Detroit, MI
    • ,
  • Yuri B. Pride, MD

      Affiliations

    • Beth Israel Deaconess Medical Center, Boston, MA
    • ,
  • Cedric Lefebvre, MD

      Affiliations

    • Wake Forest University, Winston-Salem, NC
    • ,
  • Deborah B. Diercks, MD

      Affiliations

    • University of California Davis, Sacramento, CA
    • ,
  • W. Frank Peacock, MD

      Affiliations

    • Cleveland Clinic Foundation, Cleveland, OH
    • ,
  • Gregory J. Fermann, MD

      Affiliations

    • University of Cincinnati, Cincinnati, OH
    • ,
  • C. Michael Gibson, MD

      Affiliations

    • Beth Israel Deaconess Medical Center, Boston, MA
    • ,
  • Duane Pinto, MD

      Affiliations

    • Beth Israel Deaconess Medical Center, Boston, MA
    • ,
  • Jim Giglio, MD

      Affiliations

    • New York Presbyterian Hospital, New York, NY
    • ,
  • Abhinav Chandra, MD

      Affiliations

    • Duke University Medical Center, Durham, NC
    • ,
  • Charles B. Cairns, MD

      Affiliations

    • University of North Carolina, Chapel Hill, NC
    • ,
  • Marvin A. Konstam, MD

      Affiliations

    • Tufts University Medical Center, Boston, MA
    • ,
  • Joe Massaro, PhD

      Affiliations

    • Boston University, Boston, MA
    • ,
  • Mitchell Krucoff, MD

      Affiliations

    • Duke University Medical Center, Durham, NC

Received 3 April 2009 ,Revised 16 June 2009 ,Accepted 24 June 2009.

References 

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  19. McClelland AJ, Owens CG, Menown IB, et al. Comparison of the 80-lead body surface map to physician and to 12-lead electrocardiogram in detection of acute myocardial infarction. Am J Cardiol. 2003;92:252–257
  20. Menown IB, Allen J, Anderson JM, et al. ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction. Eur Heart J. 2001;22:218–227
  21. Ornato JP, Menown IB, Riddell JW, et al. 80-Lead body map detects acute ST elevation myocardial infarction missed by standard 12-lead electrocardiography. J Am Coll Cardiol. 2002;39:332A
  22. Menown IB, Allen J, Anderson JM, et al. Early diagnosis of right ventricular or posterior infarction associated with inferior wall left ventricular acute myocardial infarction. Am J Cardiol. 2000;85:934–938
  23. Kornreich F, Montague TJ, Rautaharju PM. Body surface potential mapping of ST segment changes in acute myocardial infarction (Implications for ECG enrollment criteria for thrombolytic therapy). Circulation. 1993;87:773–782
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  26. Lefebvre C, Hoekstra JW. Early detection and diagnosis of acute myocardial infarction: the potential for improved care with next-generation, user-friendly ECG body surface mapping. Am J Emerg Med. 2007;25:1063–1072
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 Supervising editor: Judd E. Hollander, MD

 Author contributions: JWH and MK were the co–principal investigators. JWH was responsible for primary article preparation. JWH, JG, MAK, and MK were responsible for study design. BJO, CL, DD, GJF, and AC were the site principal investigators. BJO, CL, DD, and JG enrolled patients. BJO, JG, and MAK were members of the steering committee. BJO, YP, CD, DD, WFP, GJF, CMG, DP, MAK, and MK were responsible for article editorial assistance. YP, CMG, and DP conducted angiographic analysis. CL, AC, CBC, and MK conducted ECG core laboratory analysis. JWH, JM, and MK conducted data analysis. JM conducted statistical analysis. JWH takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflicts of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. The trial was funded by Heartscape, Inc., the makers of the 80-lead technology. The data were collated and analyzed by an independent contract research organization (CCT, Inc.). The steering committee had full control of the study design, and CCT had complete control of the data, without sponsor influence. The authors do not hold stock in the company, although a few have served as consultants to the company in trial design and product development. The authors have had complete access to and control of the data and complete freedom with data analysis and results presentation in this article, without influence from Heartscape.

 Reprints not available from the authors.

 Publication date: Available online September 19, 2009.

PII: S0196-0644(09)01223-2

doi: 10.1016/j.annemergmed.2009.06.525

Annals of Emergency Medicine
Volume 54, Issue 6 , Pages 779-788.e1 , December 2009

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