Recording lead V(4)R is associated to enhanced use of fibrinolytic therapy in acute myocardial infarction.

Background: ST-segment elevation in the right-sided chest lead V(4)R in inferior wall myocardial infarction is recognized as a sign of proximal occlusion of the right coronary artery with evolving right ventricular myocardial infarction. Our objective is to study how often lead V(4)R is recorded in clinical practice and how this might be associated with use of reperfusion therapy and outcome of patients.

Methods: Recording of lead V(4)R in 814 consecutive patients with acute myocardial infarction, administration of therapy, and outcome of the patients during a median follow-up of 285 days (174-313 days) were studied.