Sgarbossa's = 0

Criteria for identifying STEMI in LBBB.

Concordance: the ST segment is deviated from the baseline in the same direction as the most prominent wave of the QRS complex (ex: R wave > S wave and ST segment is above the baseline)

Sensitivity and specificity for coronary occlusion confirmed by cath reports on patients with chest pain / dyspnea and LBBB.

Sens.Spec.
Modified Sgarbossa80-91%90-100%
Original Sgarbossa50%98-100%

Meyers, HP et al. Validation of the modified Sgarbossa criteria for acute coronary occlusion in the setting of left bundle branch block: A retrospective case-control study. Am Heart J. 2015; 170(6): 1255-64.

Smith SW et al. Diagnosis of ST-elevation myocardial infarction in the presence of left bundle branch block with the ST-elevation to S-wave ratio in a modified Sgarbossa rule. Ann Emerg Med. 2012; 60(6):766-76. Text

Sgarbossa EB et al. Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. N Engl J Med. 1996; 334(8):481-7.