Quantifying QRS changes during myocardial ischemia: Insights from high frequency electrocardiography

Guy Amit, Yair Granot, Shimon Abboud

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Over four decades of high frequency electrocardiography research have provided a body of knowledge about QRS changes during myocardial ischemia, and the techniques to measure and quantify them. High-frequency QRS (HFQRS) components, being closely related to the pattern of ventricular depolarization, carry valuable clinical information. Changes in HFQRS amplitude and morphology have been shown to be sensitive diagnostic markers of myocardial ischemia, often superior to measures of ST-T segment changes. Clinical studies in patients undergoing exercise testing have consistently demonstrated the incremental diagnostic value of HFQRS analysis in detection of demand ischemia. In 6 studies that evaluated the HyperQ™ technology, the average sensitivity and specificity of HFQRS analysis were 75% ± 6% and 80% ± 6%, respectively, compared to average sensitivity 48% ± 16% and average specificity 70% ± 15% of ST segment analysis. In patients with acute supply ischemia, recent studies characterized and quantified the ischemic HFQRS patterns. HFQRS morphology index was found to be higher in patients with acute coronary syndrome (ACS), compared to non-ischemic, with good sensitivity in patients without ST elevation. These research findings may be translated into commercially-available ECG systems and be used in clinical practice for improved diagnosis and monitoring of myocardial ischemia.

Original languageEnglish
Pages (from-to)505-511
Number of pages7
JournalJournal of Electrocardiology
Issue number4
StatePublished - 1 Jan 2014
Externally publishedYes


  • High frequency electrocardiography
  • Myocardial ischemia
  • QRS changes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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