Prevalence of junctional ST-depression with tall symmetrical T-waves in a pre-hospital field triage system for STEMI patients

Ruben W. de Winter, Rob Adams, Giovanni Amoroso, Yolande Appelman, Lucia ten Brinke, Bart Huybrechts, Pieternel van Exter, Robbert J. de Winter

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: The prevalence of the junctional ST-depression with tall symmetrical T-waves in a field triage system for ST-Elevation Myocardial Infarction (STEMI) is unknown. Material and methods: We prospectively collected all transmitted 12-lead electrocardiograms (ECGs) from the STEMI field triage system in Amsterdam from 2011 to 2013. Electrocardiograms with junctional ST-depression with tall symmetrical T-waves were recognized and angiographic documentation and clinical follow up were collected. Results: A total of 5588 patients with at least 1 transmitted field ECG were identified from the database. ST-elevation infarction was present on the field ECG in 1864 patients (33%) and 701 ECGs (12,5%) showed anterior infarction. In 11 patients, junctional ST-depression with tall symmetrical T-waves was identified (0,2% of total transmitted ECGs and 1,6% of anterior infarctions). The 11 angiograms invariably showed involvement of the proximal Left Anterior Descending (LAD) artery (segment 5,6 and 7). Mortality was 27% within the first week. Conclusions: An ECG with junctional ST-depression with tall symmetrical T-waves is an infrequent finding. Because this pattern of STEMI equivalent is associated with LAD occlusions, it is important to recognize this pattern, so patients can be transported to the catheterization laboratory without delay.
LanguageEnglish
Pages1-5
JournalJournal of Electrocardiology
Volume52
DOIs
StatePublished - 2019

Cite this

de Winter, Ruben W. ; Adams, Rob ; Amoroso, Giovanni ; Appelman, Yolande ; ten Brinke, Lucia ; Huybrechts, Bart ; van Exter, Pieternel ; de Winter, Robbert J./ Prevalence of junctional ST-depression with tall symmetrical T-waves in a pre-hospital field triage system for STEMI patients. In: Journal of Electrocardiology. 2019 ; Vol. 52. pp. 1-5
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title = "Prevalence of junctional ST-depression with tall symmetrical T-waves in a pre-hospital field triage system for STEMI patients",
abstract = "Introduction: The prevalence of the junctional ST-depression with tall symmetrical T-waves in a field triage system for ST-Elevation Myocardial Infarction (STEMI) is unknown. Material and methods: We prospectively collected all transmitted 12-lead electrocardiograms (ECGs) from the STEMI field triage system in Amsterdam from 2011 to 2013. Electrocardiograms with junctional ST-depression with tall symmetrical T-waves were recognized and angiographic documentation and clinical follow up were collected. Results: A total of 5588 patients with at least 1 transmitted field ECG were identified from the database. ST-elevation infarction was present on the field ECG in 1864 patients (33{\%}) and 701 ECGs (12,5{\%}) showed anterior infarction. In 11 patients, junctional ST-depression with tall symmetrical T-waves was identified (0,2{\%} of total transmitted ECGs and 1,6{\%} of anterior infarctions). The 11 angiograms invariably showed involvement of the proximal Left Anterior Descending (LAD) artery (segment 5,6 and 7). Mortality was 27{\%} within the first week. Conclusions: An ECG with junctional ST-depression with tall symmetrical T-waves is an infrequent finding. Because this pattern of STEMI equivalent is associated with LAD occlusions, it is important to recognize this pattern, so patients can be transported to the catheterization laboratory without delay.",
author = "{de Winter}, {Ruben W.} and Rob Adams and Giovanni Amoroso and Yolande Appelman and {ten Brinke}, Lucia and Bart Huybrechts and {van Exter}, Pieternel and {de Winter}, {Robbert J.}",
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Prevalence of junctional ST-depression with tall symmetrical T-waves in a pre-hospital field triage system for STEMI patients. / de Winter, Ruben W.; Adams, Rob; Amoroso, Giovanni; Appelman, Yolande; ten Brinke, Lucia; Huybrechts, Bart; van Exter, Pieternel; de Winter, Robbert J.

In: Journal of Electrocardiology, Vol. 52, 2019, p. 1-5.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Prevalence of junctional ST-depression with tall symmetrical T-waves in a pre-hospital field triage system for STEMI patients

AU - de Winter,Ruben W.

AU - Adams,Rob

AU - Amoroso,Giovanni

AU - Appelman,Yolande

AU - ten Brinke,Lucia

AU - Huybrechts,Bart

AU - van Exter,Pieternel

AU - de Winter,Robbert J.

PY - 2019

Y1 - 2019

N2 - Introduction: The prevalence of the junctional ST-depression with tall symmetrical T-waves in a field triage system for ST-Elevation Myocardial Infarction (STEMI) is unknown. Material and methods: We prospectively collected all transmitted 12-lead electrocardiograms (ECGs) from the STEMI field triage system in Amsterdam from 2011 to 2013. Electrocardiograms with junctional ST-depression with tall symmetrical T-waves were recognized and angiographic documentation and clinical follow up were collected. Results: A total of 5588 patients with at least 1 transmitted field ECG were identified from the database. ST-elevation infarction was present on the field ECG in 1864 patients (33%) and 701 ECGs (12,5%) showed anterior infarction. In 11 patients, junctional ST-depression with tall symmetrical T-waves was identified (0,2% of total transmitted ECGs and 1,6% of anterior infarctions). The 11 angiograms invariably showed involvement of the proximal Left Anterior Descending (LAD) artery (segment 5,6 and 7). Mortality was 27% within the first week. Conclusions: An ECG with junctional ST-depression with tall symmetrical T-waves is an infrequent finding. Because this pattern of STEMI equivalent is associated with LAD occlusions, it is important to recognize this pattern, so patients can be transported to the catheterization laboratory without delay.

AB - Introduction: The prevalence of the junctional ST-depression with tall symmetrical T-waves in a field triage system for ST-Elevation Myocardial Infarction (STEMI) is unknown. Material and methods: We prospectively collected all transmitted 12-lead electrocardiograms (ECGs) from the STEMI field triage system in Amsterdam from 2011 to 2013. Electrocardiograms with junctional ST-depression with tall symmetrical T-waves were recognized and angiographic documentation and clinical follow up were collected. Results: A total of 5588 patients with at least 1 transmitted field ECG were identified from the database. ST-elevation infarction was present on the field ECG in 1864 patients (33%) and 701 ECGs (12,5%) showed anterior infarction. In 11 patients, junctional ST-depression with tall symmetrical T-waves was identified (0,2% of total transmitted ECGs and 1,6% of anterior infarctions). The 11 angiograms invariably showed involvement of the proximal Left Anterior Descending (LAD) artery (segment 5,6 and 7). Mortality was 27% within the first week. Conclusions: An ECG with junctional ST-depression with tall symmetrical T-waves is an infrequent finding. Because this pattern of STEMI equivalent is associated with LAD occlusions, it is important to recognize this pattern, so patients can be transported to the catheterization laboratory without delay.

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