Abstract 17782: In the Prehospital Setting the Glasgow Algorithm for Electrocardiogram Analysis is not Specific in Patients With Suspected ST Elevation Myocardial Infarction

Introduction: The University of Glasgow 12-Lead ECG Analysis Algorithm (GA) has a reported sensitivity of 78% and specificity of 94% for the diagnosis of STEMI in the prehospital setting. Aim: To assess the accuracy of the GA in the prehospital setting in patients with suspected STEMI. Methods: Prehospital ECGs from patients with suspected ACS between 2010 and 2013 on LIFEPAK15 units with GA interpretation capability were transmitted to interventional cardiologists by paramedics. Independent interpretation of ST elevation criteria of ≥1mm (except ≥2mm in men ≥ 40 years, ≥2.5mm in men < 40 years or ≥ 1.5 mm in women in leads V1-3) in ≥2 contiguous leads, was performed retrospectively by two cardiology fellows with 20% cross-reading by an interventional cardiologist; MI adjudication used the Third Universal Definition. Disagreements were resolved by consensus. Results: Of the 580 transmitted ECGs, 91(7.5%) were excluded (missing information or duplicate/serial). Of the remaining 489 transmitted ECGs, 342 (7...