Page 571 - ECG dr shamol_Slide

The criteria (Sgarbossa [1]) that can be used in case of a LBBB and suspicion of

infarction are:

ST elevation > 1mm in leads with a positive QRS complex (concordance in ST

deviation) (score 5)

ST depression > 1 mm in V1-V3 (concordance in ST deviation) (score 3)

ST elevation > 5 mm in leads with a negative QRS complex (inappropriate

discordance in ST deviation) (score 2)

. This criterion is sensitive, but not specific for ischemia in LBBB. It is however

associated with a worse prognosis, when present in LBBB during ischemia.[2]

At a score-sum of 3, these criteria have a specificity of 90% for detecting a

myocardial infarction