Correlation of polarcardiographic criteria for myocardial infarction with arteriographic and ventriculographic findings (substantiation of transmural and presentation of non-transmural criteria).

Sensitivity and specificity of polarcardiographic criteria for myocardial infarction were compared with those of electrocardiographic criteria in 108 patients with chest pain syndromes who were referred for coronary arteriography and left ventriculography. With the combination of total occlusion of at least one coronary artery and abnormal systolic contraction of at least part of the left ventricle as the best available documentation of myocardial disease, sensitivity and specificity were 70% and 67%, respectively, using electrocardiographic criteria and 80% and 73% using polarcardiographic criteria, for both anterior and inferior myocardial infarction. Another polarcardiographic criterion--rightward shift in R latitude at 10 msec after onset of QRS--occurred concurrently with vessel occulusion in 16 of 17 patients (94%), in four of whom this was the only objective evidence of myocardial infarction, and three of whom there was no manifest abnormality of wall contraction. This criterion is considered evidence of non-transmural myocardial infarction, probably in the subendocardial layer near the apex of the left ventricle. When such evidence is added, sensitivity of polarcardiographic criteria increased to 84%, and specificity decreased to equal that of the electrocardiographic criteria (67%).