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J Electrocardiol. 2010 May-Jun;43(3):215-9. doi: 10.1016/j.jelectrocard.2009.12.004. Epub 2010 Jan 13.

Significance of a prominent Q wave in lead negative aVR (-aVR) in acute anterior myocardial infarction.

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Internal Medicine 2, Oita University, Idaigaoka 1-1, Yufu, Japan.



The aim of this study was to clarify the significance of a Q wave in lead negative aVR (-aVR) in anterior wall acute myocardial infarction (AMI).


Eighty-seven patients with a first anterior wall AMI were classified into 2 groups according to the presence (n = 17, group A) or absence (n = 70, group B) of a prominent Q wave (duration > or =20 milliseconds) in lead -aVR at predischarge. Group A had a higher prevalence of a long left anterior descending coronary artery (LAD), a lower left ventricular ejection fraction, and more reduced regional wall motion in the apical and inferior regions than group B. None of group A patients had an LAD that did not reach the apex.


A prominent Q wave in lead -aVR in anterior wall AMI is related to severe regional wall motion abnormality in the apical and inferior regions, with an LAD wrapping around the apex.

[Indexed for MEDLINE]

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