Acute Myocardial Infarction With ST Segment Elevation Clinical Trial
— Nehb-STEMIOfficial title:
Nehb 3-Lead Bipolar Leads for Rapid Diagnosis & Treatment of STEMI
The method of ECG recording with the use of three bipolar leads A (anterior), D dorsalis)
and J (or I - inferior) was introduced in 1938 by German electrophysiologist W. Nehb. Being
positioned on the chest in the immediate proximity to the heart, and being aligned to the
anatomic position of the heart, these leads are very sensitive and allow accurate
diagnostics of different heart conditions. All the active leads are placed on anterolateral
plane of the chest wall requiring little anatomical window making this technique convenient
for express diagnostics using compact electrocardiographic devices without any loss of
valuable information.
Active electrodes are located on the chest in the following order: 1st- red standard
electrode placed in the second intercostal space to the right from sternum corresponding to
V1 for standard 12-lead ECG recording, 2nd- green standard lead placed in the position
corresponding to V4; 3rd- yellow in the position V7. Then ECG recorded as if in the I
standard lead would be defined as Nehb's D, which records the potential on the posterior
left ventricle wall; II standard lead would produce Nehb's A which corresponds to the
potential on the anterior wall of the left ventricle, and III standard lead would record
Nehb's J, which reflects the potential on the diaphragmatic surface of heart.
Been simple and informative, this ECG recording modality may be applicable for usage with
compact portable cardiographer devices for express diagnosis in different situations and may
allow faster and more adequate outpatient response in the case of emergencies.
Nehb 3 leads ECG can provide the clinician with portable, reliable, comprehensive and
constant ECG monitoring and by this facilitate rapid diagnosis and treatment of STEMI.
| Status | Recruiting |
| Enrollment | 100 |
| Est. completion date | August 2008 |
| Est. primary completion date | May 2008 |
| Accepts healthy volunteers | No |
| Gender | Both |
| Age group | 18 Years and older |
| Eligibility |
Inclusion criteria: 1. Age = 18 years 2. ST elevation in more than 2 contiguous leads (> 1 mV in limb leads & V5-V6; more than 2 mm in V1-V4) 3. Complains of chest, neck, jaw, arm, epigastric or back pain or dyspnea 4. Patients directly transferred to the coronary care unit. Exclusion criteria: 1. Unconscious patients 2. Unwillingness to participate in the study 3. Presence of LBBB |
Observational Model: Case-Only, Time Perspective: Prospective
| Country | Name | City | State |
|---|---|---|---|
| Israel | Assaf Harofeh Medical Center Intensive Coronary Care Unit | Zerifin |
| Lead Sponsor | Collaborator |
|---|---|
| Assaf-Harofeh Medical Center |
Israel,
Nehb W. Zur Standardisierung der Brustwandableitungen des Elektrokardiogrammen. Kin. Wochenschz. 17 (1938):1807-1811.// Pollock, P. A comparison of Nehb's bipolar chest leads and the standard 12-lead electrocardiogram in cases of myocardial infarction. American Heart Journal, Research Assistant in Medicine. (1955) 68-71.// De Luca et al: Time Delay to Treatment and Mortality in Primary Angioplasty for Acute Myocardial Infarction: Every Minute of Delay Counts. Circulation 109 (2004): 1224// Atar et al: Electrocardiographic Diagnosis of ST-elevation Myocardial Infarction. Cardiol Clin 24 (2006) 343-365// V. N. Dhruva et al: ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction (STAT-MI) Trial J. Am. Coll. Cardiol. 2007;50;509-513//
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Primary | Evidence of ST Elevations in Nehb Tracing in all patients with determined STEMI in Standard 12-leads ECG. | On patients' admition to EMS/ICCU | No |