Electrocardiography Committee Appointed by the International Society for Holter and Noninvasive Resonance Imaging: A Statement for Healthcare Professionals From a Infarcts That Present Q Wave Based on the Standard of Cardiac Magnetic A New Terminology for Left Ventricular Walls and Location of My... (original) (raw)

T he ECG is the most frequently used tool for evaluating myocardial infarction (MI). The ECG provides an opportunity to describe location and extent of infarction expressed as pathological Q waves or their equivalents. The terminology used for the left ventricular (LV) walls has varied over time, 1-7 although the most currently accepted terms by electrocardiographists have been anterior, septal, lateral, and inferior. 8 -15 However, terminology has been complicated by use of posterior to refer to either the basal lateral or the basal inferior wall (see below). On the basis of correlations with the postmortem anatomic gold standard reported Ͼ50 years ago 16 and confirmed later, 17,18 the presence of abnormal Q waves in leads V 1 and V 2 was related to septal wall MI; in V 3 and V 4 to anterior wall MI; in V 5 and V 6 , I, and aVL to lateral wall MI (I, aVL high lateral; V 5 and V 6 , low lateral); and in II, III, and aVF to inferior wall MI. The presence of abnormally increased R waves in V 1 and V 2 as a mirror image of Q waves in posterior leads was called a posterior wall infarction. Although similar considerations may be applied for ECG location of ST-segment deviation, this report focuses only on ECG localization of the QRScomplex abnormalities indicative of established MI as depicted by cardiac magnetic resonance (CMR) imaging.