Comparison of different electrocardiographic criteria for the detection of previous myocardial infarction in relation to infarct characteristics as assessed with cardiovascular magnetic resonance imaging

Background The electrocardiogram (ECG) is often used as initial test to detect or rule out previous myocardial infarction (MI). Although different ECG-criteria with considerable heterogeneity are used for this purpose, their accuracy is not well described. We aimed to determine the diagnostic accuracy of four commonly used ECG-criteria for detecting previous MI: 1) the universal definition of previous MI, 2) the Minnesota ECG-code (MC), 3) the Selvester QRS-score, and 4) assessment by cardiologists, using delayed-enhancement cardiovascular magnetic resonance imaging (DE-CMR) as reference standard. Also the effect of different ECG and infarct characteristics on detecting previous MI were evaluated.