{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:22:17Z","timestamp":1789496537403,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,7,21]]},"abstract":"\n Background<\/jats:title>\n \n Current electrocardiographic algorithms lack sensitivity to diagnose acute myocardial infarction (\n AMI<\/jats:styled-content>\n ) in the presence of left bundle branch block.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n A multicenter retrospective cohort study including consecutive patients with suspected\n AMI<\/jats:styled-content>\n and left bundle branch block, referred for primary percutaneous coronary intervention between 2009 and 2018. Pre\u20102015 patients formed the derivation cohort (n=163, 61 with\n AMI<\/jats:styled-content>\n ); patients between 2015 and 2018 formed the validation cohort (n=107, 40 with\n AMI<\/jats:styled-content>\n ). A control group of patients without suspected\n AMI<\/jats:styled-content>\n was also studied (n=214). Different electrocardiographic criteria were tested. A total of 484 patients were studied. A new electrocardiographic algorithm (\n BARCELONA<\/jats:styled-content>\n algorithm) was derived and validated. The algorithm is positive in the presence of\n ST<\/jats:styled-content>\n deviation \u22651\u00a0mm (0.1\u00a0mV) concordant with\n QRS<\/jats:styled-content>\n polarity, in any lead, or\n ST<\/jats:styled-content>\n deviation \u22651\u00a0mm (0.1\u00a0mV) discordant with the\n QRS<\/jats:styled-content>\n , in leads with max (R|S) voltage (the voltage of the largest deflection of the\n QRS<\/jats:styled-content>\n , ie, R or S wave) \u22646\u00a0mm (0.6\u00a0mV). In both the derivation and the validation cohort, the\n BARCELONA<\/jats:styled-content>\n algorithm achieved the highest sensitivity (93%\u201395%), negative predictive value (96%\u201397%), efficiency (91%\u201394%) and area under the receiver operating characteristic curve (0.92\u20130.93), significantly higher than previous electrocardiographic rules (\n P<\/jats:italic>\n <0.01); the specificity was good in both groups (89%\u201394%) as well as the control group (90%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In patients with left bundle branch block referred for\n primary percutaneous coronary intervention<\/jats:styled-content>\n , the\n BARCELONA<\/jats:styled-content>\n algorithm was specific and highly sensitive for the diagnosis of\n AMI<\/jats:styled-content>\n , leading to a diagnostic accuracy comparable to that obtained by\n ECG<\/jats:styled-content>\n in patients without left bundle branch block.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.015573","type":"journal-article","created":{"date-parts":[[2020,7,4]],"date-time":"2020-07-04T09:50:52Z","timestamp":1593856252000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["New Electrocardiographic Algorithm for the Diagnosis of Acute Myocardial Infarction in Patients With Left Bundle Branch Block"],"prefix":"10.1161","volume":"9","author":[{"given":"Andrea","family":"Di Marco","sequence":"first","affiliation":[{"name":"Heart Disease Institute Bellvitge University Hospital Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Heart Disease Institute Bellvitge University Hospital Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Cinca","sequence":"additional","affiliation":[{"name":"Cardiology Department Hospital de la 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