Myocardial Infarction Clinical Trial
Official title:
Comparison of Estimated Body Surface Potential Mapping With Standard Electrocardiography in Patients Presenting to the Emergency Department With Chest Pain
The aim of this study is to improve the detection of heart attack in people who come to a hospital emergency room (ER) with cardiac symptoms. We are testing a novel technology that calculates the heart's electrical activity at points all around the upper body torso and develops a map showing areas indicating heart attack. Our hypothesis is that this new body mapping technique will be better than the standard electrocardiogram (ECG) in detecting heart attack.
The overall aims of the proposed research are (1) to improve the ECG diagnosis of patients
who present to the ER with heart attack and (2) to improve the monitoring of recurrent heart
attack in these patients while they are being treated in the hospital. The proposed research
will test a promising new technique, termed estimated body surface potential mapping. This
novel method involves estimating ECG information across the entire upper body from 10
electrodes placed in strategic positions.
In patients who come to the ER complaining of chest pain, shortness of breath or some other
symptom of a heart attack, we will: (1) record continuous, 24 hour, standard ECGs (usual,
current method used) and at the same time (2)record continuous 24 hour experimental
recordings from which a body surface map will be calculated. Two experts who do not know
whether the patient actually had a heart attack or not will analyze these 2 methods for
signs of heart attack. We expect that more correct diagnoses will happen with the new
experimental body mapping technique. The correct diagnosis will be based upon a blood test
which is considered the best test to prove there is heart damage. The blood test does not
become abnormal until hours after the attack, however, so the ECG diagnosis must be made and
treatment initiated before results of the blood test are available.
If the expected diagnostic improvements are confirmed in this study, the long term benefit
would be more accurate ER decision-making of patients with heart attack and more timely
treatment. The benefits of more timely and definitive treatment would be an improvement in
long-term survival, functional status, and quality of life in patients treated for heart
attack.
We plan to enroll 1,320 patients who present to the ER at the University of California, San
Franicsco to participate in the study. We will follow these patients for a year following
their ER visit to determine whether they survived and which ECG method predicted death more
accurately.
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Observational Model: Defined Population, Primary Purpose: Screening, Time Perspective: Longitudinal
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