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Culprit Coronary Artery Algorithm
7
User guide
Introduction
7.1
CARDIOVIT AT-1 G2
7 Culprit Coronary Artery
Algorithm
7.1 Introduction
The Culprit Coronary Artery Algorithm developed by Professor Hein Wellens is
designed to determine the size of the cardiac area at risk by localising the occlusion
site in the coronary artery and to provide clinical data to shorten the time interval
between the onset of chest pain and restoration of myocardial blood flow, as well as
to ensure that the patient is assigned to the most suitable hospital. The algorithm uses
the ST segment deviation of 12 ECG leads to indicate the site of occlusion in the
culprit artery.
The closer the occlusion site to the origin of the coronary artery, the larger the size of
the area at risk. The algorithm indicates the location of the occlusion site and issues
a recommendation based on the ECG data and patient history. The recommendation
is based on the following:
•
Prior Bypass/ Stent.
This data is entered before the ECG recording is taken (see
section 6.1 Resting ECG - Procedural Flow Diagram, page 30
). If the patient has
had prior bypass or stent, the ECG is not analysed further and the advice
Go to
PCI centre (P
ercutaneous
C
oronary
I
ntervention) is given.
•
ST Score
. The sum of the absolute ST deviations in mm in 12 leads (excluding
V4r). That is the total ST deviation (mm) of all leads (I, II, III, aVR, aVL, aVF, and
all leads V1 to V6).
•
Occlusion Site.
The calculated occlusion site.
The site of occlusion is determined by the following:
1. The number of leads indicating a occlusion are counted (= sum)
2. The occlusion site with the highest number is chosen as the occluded location.
3. If two locations have an equal value, then the more critical occlusion site (highest
in the artery) is selected.