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(Circulation. 2006;114:1755-1760.)
© 2006 American Heart Association, Inc.

Special Report

A New Terminology for Left Ventricular Walls and Location of Myocardial Infarcts That Present Q Wave Based on the Standard of Cardiac Magnetic Resonance Imaging

A Statement for Healthcare Professionals From a Committee Appointed by the International Society for Holter and Noninvasive Electrocardiography

Antoni Bayés de Luna, MD; Galen Wagner, MD; Yochai Birnbaum, MD; Kjell Nikus, MD; Miguel Fiol, MD; Anton Gorgels, MD, PhD; Juan Cinca, MD; Peter M. Clemmensen, MD; Olle Pahlm, MD; Samuel Sclarovsky, MD; Shlomo Stern, MD; Hein Wellens, MD; Wojciech Zareba, MD

From the Institut Català Ciències Cardiovasculars, Hospital Sant Pau, Barcelona, Spain (A.B.d.L.); Duke University Medical Center, Durham, NC (G.W.); The Heart Station, Division of Cardiology, Galveston, Tex (Y.B.); Heart Center, Tampere, Finland (K.N.); Hospital Son Dureta, Palma Mallorca, Spain (M.F.); Department of Cardiology, University Hospital Maastricht, Maastricht, Netherlands (A.G.); Department of Cardiology, Hospital Santa Creu i Sant Pau, Barcelona, Spain (J.C.); The Heart Center, Rigshospitalet, Copenhagen, Denmark (P.M.C.); University Hospital Lasarettet, Lund, Sweden (O.P.); Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel (S. Sclarovsky); Hebreus University of Jerusalem, Jerusalem, Israel (S. Stern); Cardiovascular Research Institute, Maastricht, Netherlands (H.W.); and Medical Center, University of Rochester, Rochester, NY (W.Z.).

Correspondence to Antonio Bayés de Luna, MD, FESC, Institut Català Ciències Cardiovasculars, Hospital Sant Pau, S Antoni M. Claret 167, 08025 Barcelona, Spain. E-mail abayesluna@santpau.es

Key Words: electrocardiography • infarction • magnetic resonance imaging

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
The 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 >50 years ago¹⁶ and confirmed later,^17,18 the presence of abnormal Q waves in leads V₁ and V₂ was related to septal wall MI; in V₃ and V₄ to anterior wall MI; in V₅ and V₆, I, and aVL to lateral wall MI (I, aVL high lateral; V₅ and V₆, low lateral); and in II, III, and aVF to inferior wall MI. The presence of abnormally increased R waves in V₁ and V₂ 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 QRS-complex abnormalities indicative of established MI as depicted by cardiac magnetic resonance (CMR) imaging.

Although attempts to standardize the terminology applied to the LV walls have been reported,^19,20 differences persist among the terms used by anatomists, pathologists, electrocardiographists, . . . [Full Text of this Article]

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