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Christiaan J M Vrints, The 12 lead ECG rules the waves in acute cardiovascular care, European Heart Journal. Acute Cardiovascular Care, Volume 7, Issue 3, 1 April 2018, Pages 197–199, https://doi.org/10.1177/2048872618772407
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Although a wide array of very sophisticated diagnostic techniques is available to the modern cardiologist, the basic 12 lead electrocardiogram (ECG) remains the cornerstone in the clinical assessment of acute cardiac syndromes in the prehospital setting, in the emergency department, in the intensive cardiac care unit and in the hospital ward. In acute coronary syndromes (ACS) the 12-lead ECG is the first line diagnostic test that needs to be recorded within 10 minutes after the first medical contact.1, 2 Especially in the assessment of patients with a suspected ST segment elevation myocardial infarction (STEMI) the initial 12 lead ECG plays a pivotal role as it triggers the decision to send the patients for urgent primary percutaneous intervention (PCI). Although the diagnostic algorithms for automated computerized interpretation of the ECG have improved considerably there remain frequent incorrect readings of arrhythmias, conduction disorders and pacemaker rhythms and a wide variation in the diagnostic accuracy in the identification of STEMI.3 Proficiency in rapid and accurate ECG interpretation remains therefore a necessary skill for all cardiologists and all allied professions working in acute cardiac care. Moreover, although the ECG is already there for 100 years, it remains important to develop and to assess new diagnostic criteria and to relate specific ECG patterns with clinical conditions and their outcomes in order to further improve the diagnostic accuracy and clinical utility of this readily and universally available bedside examination technique. In this issue a special focus is on specific ECG features and on the role of the basic 12 lead ECG in different acute cardiovascular diseases.
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