• D L Justis and W T Hession.
• Department of Emergency Medicine, Fairview Southdale Hospital, Edina, MN.
• Ann Emerg Med. 1992 Jan 1; 21 (1): 1-9.

Study ObjectivesTo compare a new 22-lead ECG with the 12-lead ECG for diagnosis of acute myocardial infarction (AMI).DesignProspective study of all consenting patients presenting to the emergency department with chest pain.SettingUrban hospital ED.Type Of Participants163 patients admitted with a cardiac-related diagnosis and complete data sets of 22- and 12-lead ECG results and creatine kinase-MB analysis.InterventionsPatient care and existing protocols were unaltered, with the exception of including the new 22-lead ECG.Measurements And Main ResultsForty-one of 163 patients had an AMI as defined by creatine kinase-MB analysis. The 22-lead ECG provided a statistically significant improvement in sensitivity (83%) for AMI diagnosis over the 12-lead ECG (51%) with specificities of 76% and 99%, respectively.ConclusionWhen combined with clinical judgment, the 22-lead ECG could provide a 97.6% sensitivity for AMI diagnosis while reducing unnecessary admissions for "rule-out MI" by 69%.

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