Serial ECG analysis after myocardial infarction: When heart failure develops, the ECG becomes increasingly discordant

This study sought to identify an ECG variable that can be used to detect emerging heart failure (HF) in patients after myocardial infarction (MI). We adopted the spatial QRS-T angle (SA) as a measure of ECG concordance, and hypothesized that the ECG of patients who develop HF becomes less concordant. We computed SA in ECGs of 20 patients (15/5 male/female, mean±SD age 64±10 yrs), at baseline (6 months after MI) and 3.8±2.4 yrs later, when they presented with HF. SA increased from 97±36° to 119±34° (P=0.003). SA decreased only in 4 pts. We conclude that SA is potentially a suitable ECG monitoring variable for early detection of HF after MI.