High-frequency QRS analysis in the evaluation of chest pain in the emergency department

Ori Galante*, Guy Amit, Yair Granot, Linda R. Davrath, Shimon Abboud, Doron Zahger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives High frequency QRS (HFQRS) analysis has been shown to be an accurate marker for myocardial ischemia. Our objective was to test the use of HFQRS in diagnosing ACS in the emergency department. Methods 324 patients presenting to the ED with chest pain were enrolled. Resting ECG was recorded and later analyzed by an HFQRS algorithm. Results were compared to the conventional ECG diagnosis by 3 independent interpretations: treating physician, expert cardiologist and an automated computer program. Results The HFQRS analysis demonstrated improved sensitivity (67.5%) for the NSTE-ACS group compared to the human interpreters (59.7% and 53.2% for the treating physician and cardiologist respectively) with similar specificity. The automatic program had significantly lower sensitivity (31%) with a higher specificity (77%). Conclusions HFQRS which has shown great promise in diagnosing stable CAD may also be helpful in the ED for diagnosing ACS.

Original languageEnglish
Pages (from-to)457-465
Number of pages9
JournalJournal of Electrocardiology
Issue number4
StatePublished - Jul 2017


  • Acute coronary syndrome
  • Acute myocardial infarction
  • Chest pain
  • Electrocardiography
  • High-frequency ECG
  • Myocardial ischemia


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