Feasibility of High Frequency QRS Analysis in Patients With Acute Myocardial Infarction

Study Overview
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Brief Summary
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The primary objective of this study is to characterize the morphological patterns of high frequency QRS components (HFQRS) in patients with acute myocardial infarction (AMI), including STEMI and NSTEMI, compared to patients without AMI.

Detailed Description
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Chest pain is one of the leading reasons of hospital emergency department (ED) visits worldwide. In the US, approximately 6 million people annually undergo evaluation in the ED for acute chest pain. Despite the wealth of knowledge available about acute coronary syndrome (ACS), this condition continues to be among the most difficult to predict or diagnose. Misdiagnoses may lead to discharge of patients with ACS, who should have been admitted as well as costly unnecessary hospitalizations of patients who do not have ACS. More than 2/3 of the patients with ACS have unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI). Conventional ECG has low sensitivity of less than 50% in diagnosing these conditions. As the initial ECG in the ED is often non-diagnostic in ACS patients, the diagnosis of ST-elevation myocardial infarction (STEMI) during its early stages may also be difficult. Analysis of high-frequency QRS components (HFQRS), which quantifies changes in the depolarization phase of the cardiac cycle, has been previously reported to be a sensitive method for detection of demand ischemia. Preliminary studies have shown that HFQRS-derived indices can also identify supply ischemia caused by prolonged balloon occlusion, and transient ischemic episodes in patients with chest pain.

Official Title
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Feasibility of High Frequency QRS Analysis in Patients With Acute Myocardial Infarction

Conditions
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Myocardial Infarction

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age > 40 years (men and women) Time from onset of chest pain ≤ 12h AMI confirmed by biomarkers Clinical or electrocardiographic evidence of ischemia during recording Signed an informed consent Exclusion Criteria: Prior MI Prior CABG pre-excitation syndrome (e.g. WP) Atrial Fibrillation or significant ventricular arrhythmia BBB, intraventricular conduction delay or QRS duration > 120 ms Implanted pacemaker or defibrillator Left-ventricular hypertrophy

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| STEMI<br>Patients with ST segment elevation myocardial infarction, verified by elevated troponin levels | |
| NSTEMI<br>Patients with non-ST segment elevation myocardial infarction, verified by elevated levels of troponin | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnosis of Acute Myocardial Infarction | The primary end-point of the study is diagnosis of acute myocardial infarction, based on cardiac biomarkers, ECG changes clinical symptoms and coronary angiography. | Prior to hospitalization release | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HFQRS analysis for detecting NSTEMI | To evaluate the usefulness of HFQRS analysis in early detection of non-ST segment elevation myocardial infarction (NSTEMI). | Post data processing | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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STEMI, NSTEMI, acute ischemia, non-invasive diagnosis, elevated troponin