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 Sgarbossa | 80-91% | 90-100% |
Original Sgarbossa | 50% | 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.