Dr. Smith's ECG Blog: OMI Literature Timeline

Interobserver Variability among Experienced Electrocardiogram Readers To Diagnose Acute Thrombotic Coronary Occlusion In Patients with Out of Hospital Cardiac Arrest: Impact of Metabolic and Angiographic Culprit.

Kos N, Zeljkovic I, Krcmar T, et al.

Acute Occlusion of the Infarct-Related Artery as a Predictor of Very Long-Term Mortality in Patients with Acute Myocardial Infarction. Cardiol Res Pract. 2021; 2021:6647626. PMID 34868657.

Morawska I et al. Total Occlusion of the Infarct-Related Artery in Non-ST-Elevation Myocardial Infarction (NSTEMI) - How Can We Identify These Patients? Medicina 2021, 57(11):1196.

2022

Xu, C et al. Point-of-care ultrasound may expedite diagnosis and revascularization of occult occlusive myocardial infarction. AJEM 2022.

Lindow T et al. Low diagnostic yield of ST elevation myocardial infarction amplitude criteria in chest pain patients at the emergency department. Scandinavian Cardiovascular Journal, 55:3,145-152.

Al-Zaiti S. Macleod R. Van Dam P. Smith SW. Birnbaum Y. Emerging ECG Methods for Acute Coronary Syndrome Detection:Recommendations and Future Opportunities. J Electrocardiology 2022.

Avdikos G, Michas G, Smith SW. From Q/Non-Q Myocardial Infarction to STEMI/NSTEMI: Why it's time to consider another simplified dichotomy; a narrative literature review. Archives of Academic Emergency Medicine. 2022; 10(1):e78.

Kontos et al. 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department. JACC 2022.

Triska, J, George J, Rector G, Alam M, Smith SW, Meyers HP, Birnbaum Y. Acute Coronary Occlusion in a Patient with Prior Known Right Bundle Branch Block: Another Chink in the Armor for the STEMI Criteria. Annals of Emergency Medicine. 2022. In Press.

2023

Sharma M et al. Occluded Coronary Artery among Non-ST Elevation Myocardial Infarction Patients in Department of Cardiology of a Tertiary Care Centre: A Descriptive Cross-sectional Study. J Nepal Med Assoc 2023;61(257):54-58.

Zoni CR, Mukherjee D, Gulati M. Proposed new classification for acute coronary syndrome: acute coronary syndrome requiring immediate reperfusion. Catheterization and cardiovascular interventions, 2023, Vol.101 (7), p.1177-1181. doi:10.1002/ccd.30667

Meyers HP, Smith SW. Hyperacute T-waves Can Be a Useful Sign of Occlusion Myocardial Infarction if Appropriately Defined. Annals of Emergency Medicine 2023.

McLaren J, Meyers HP, Smith SW. Kenichi Harumi Plenary Address at Annual Meeting of the International Society of Computers in Electrocardiology: "What Should ECG Deep Learning Focus on? The diagnosis of acute coronary occlusion!" J of Electrocardiology 2023.

Spirito et al. Acute Coronary Occlusion in Patients With Non-ST-Segment Elevation Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol. 2023 Feb 7;81(5):446-456.

Guener et al. Clinical implication of totally occluded infarct-related coronary artery in non-ST-segment elevation myocardial infarction: the TOTAL-NSTEMI study. Coronary Artery Disease 21 March 2023; 34(2): 127-133(7).

Jollis et al. Treatment Time and In-Hospital Mortality Among Patients With ST-Segment Elevation Myocardial Infarction, 2018-2021. JAMA. 2022;328(20):2033-2040.

McLaren JTT, Meyers HP, Smith SW. Chest Pain, Paced Rhythm, and 2 Missed Indications for Emergent Reperfusion. JAMA Intern Med. 2023 Apr 3.

Aslanger EK. Beyond the ST-segment in Occlusion Myocardial Infarction (OMI): Diagnosing the OMI-nous. Turk J Emerg Med. 2023 Jan-Mar;23(1):1-4.

Rolek B et al. Occlusive myocardial infarction - emerging paradigm of acute coronary syndromes. Adv Interv Cardiol 2023. DOI: https://doi.org/10.5114/aic.2023.127903

Al-Zaiti et al. Machine learning for ECG diagnosis and risk stratification of occlusion myocardial infarction. Nature Medicine. 2023. https://doi.org/10.1038/s41591-023-02396-3

McLaren JTT, El-Baba M, Sivashanmugathas V, Meyers HP, Smith SW, Chartier LB. Missing occlusions: Quality gaps for ED patients with occlusion MI. AJEM 2023. https://doi.org/10.1016/j.ajem.2023.08.022

McLaren JTT, Meyers HP, Smith SW, Chartier LB. Emergency department code STEMI patients with initial ECG labelled 'normal' by computer interpretation: a 7-year retrospective review. Academic Emergency Medicine 2023. https://doi.org/10.1111/acem.14795

Muthyala A, Sasidharan S, Shringi S, et al. Is it Time for a Paradigm Shift Towards Occlusion Myocardial Infarction? JSCAI 2023. https://doi.org/10.1016/j.jscai.2023.100699

Lindow T, Mokhtari A, Nystrom A, Koul S, Smith SW, Ekelund U. Comparison of diagnostic accuracy of current left bundle branch block and ventricular pacing ECG criteria for detection of occlusion myocardial infarction. International Journal of Cardiology. 2023.

Herman, Meyers, Smith, et al. International Evaluation of an Artificial Intelligence-Powered Electrocardiogram Model Detecting Acute Coronary Occlusion Myocardial Infarction. EHJ DH. 2023.

https://doi.org/10.1093/ehjdh/ztad074

Escabi-Mendoza J, Diaz-Rodriguez P, Silva-Cantillo R. Shark Fin Occlusive Myocardial Infarction ECG pattern post-cardiac arrest misinterpreted as ventricular tachycardia. Cureus 2023. 15(5): e38708. doi: 10.7759/cureus.38708

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246928/

Geffin R, Triska J, Najjar S, Berman J, Cruse M, Birnbaum Y. Why do we keep missing left circumflex artery myocardial infarctions? Journal of Electrocardiology. 2023.

https://www.sciencedirect.com/science/article/abs/pii/S0022073623002716

2024

Abusharekh M, Kampf J, Dykun I, et al. Acute coronary occlusion with vs. without ST-elevation: impact on procedural outcomes and long-term all-cause mortality. EHJ - Quality of Care and Clinical Outcomes. 2024.

https://doi.org/10.1093/ehjqcco/qcae003

de Alencar Neto JN, Scheffer MK, Correia BP, Franchini KG, Felicioni SP, De Marchi MFN. Systematic review and meta-analysis of diagnostic test accuracy of ST-segment elevation for acute coronary occlusion. Int J Cardiol [Internet]. 2024;131889. Available from: https://www.sciencedirect.com/science/article/pii/S0167527324003358

Smith SW, Meyers HP. ST elevation is a poor surrogate for acute coronary occlusion. Let’s replace STEMI with Occlusion MI (OMI)!! International Journal of Cardiology. 2024. https://doi.org/10.1016/j.ijcard.2024.131980

de Alencar J. Feres F. Marchi M. Kleber F. Scheffer M. Silicioni S. Muniz A. Fernandes R. Ramadan H. Meyers HP. Smith SW. Beyond STEMI-NSTEMI paradigm: Instituto Dante Pazzanese's Proposal for Occlusion Myocardial Infarction Diagnosis. Arquivos Brasileiros de Cardiologia 2024: https://abccardiol.org/en/article/beyond-stemi-nstemi-paradigm-dante-pazzaneses-proposal-for-occlusion-myocardial-infarction-diagnosis/

(Abstract)

Frick W, Atallah I, Saraf R, et al. Single Center Retrospective Validation of an Artificial Intelligence ECG Model Detecting Acute Coronary Occlusion. Abstract presented at Heart Rhythm Society 2024, Boston MA, May 16.

https://www.heartrhythmjournal.com/article/S1547-5271%2824%2901176-7/fulltext

https://hqmeded-ecg.blogspot.com/2024/09/single-center-retrospective-validation.html

Gupta S, Kashou AH, Herman R, Smith SW, May A, Echeverri AGM, Sueldo MD, Berni AC, Farina J, Garcia-Zamora S, Baranchuk A. Computer-Interpreted Electrocardiograms: Impact on Cardiology Practice. Computer-Interpreted Electrocardiograms: Impact on Cardiology Practice [Internet]. 2024 [cited 2024 Jun 28];37:-. Available from: https://ijcscardiol.org/pt-br/article/computer-interpreted-electrocardiograms-impact-on-cardiology-practice/

Riek NT, Gokhale TA, Martin-Gill C, et al. Clinical usability of deep learning-based saliency maps for occlusion myocardial infarction identification from the prehospital 12-lead electrocardiogram. J of ECG. 2024.

https://www.sciencedirect.com/science/article/pii/S0022073624002620

De Alencar JN, Meyers HP, McLaren JTT, Smith SW. The No False Negative Paradox in STEMI-NSTEMI Diagnosis. Heart (BMJ). Accepted for publication on 8.22.204. https://heart.bmj.com/content/early/2024/08/30/heartjnl-2024-324512

Kola M, Shuka N, Meyers HP, Zaima E, Smith SW. OMI/NOMI: Time for a New Classification of Acute Myocardial Infarction. J. Clin. Med. 2024, 13, 5201. https://doi.org/10.3390/jcm13175201.

Baker PO, Shifa KR, Smith SW, Meyers HP, Robinson AE, Ibtida I, Karim RM, Keller GA, Royce KA, Puskarich MA. Artificial intelligence driven prehospital ECG interpretation for the reduction of false positive emergent cardiac catheterization lab activations: a retrospective cohort study. Prehospital Emergency Care. https://doi.org/10.1080/10903127.2024.2399218

(Abstract)

Sharkey S, Herman R, Larson D, Henry TD, Aguirre F, Murthey A, Rohm H, Smith SW, Yildiz M, Belzer W, Chambers J, Bergstedt S, Kerola G, Farmer D, Willett A, Witt D. Performance of Artificial Intelligence Powered ECG Analysis in suspected ST-Segment Elevation Myocardial Infarction. Abstract presented at AHA 2024 Conference, Chicago, IL, Nov 16.

(Link pending)

Avdikos G. Expertise in ECG Interpretation and Artificial Intelligence ECG Models for Occlusion Myocardial Infarction Diagnosis. Japan J Res. 2024,5(10):74.

https://www.sciencexcel.com/article/expertise-in-ecg-interpretation-and-artificial-intelligence-ecg-models-for-occlusion-myocardial-infarction-diagnosis

Tamis-Holland J, Abbott JD, Al-Azizi K,...Sandoval Y. SCAI Expert Consensus Statement on the Management of Patients with STEMI Referred for Primary PCI. Journal of the Society for Cardiovascular Angiography & Interventions, 2024.

https://www.jscai.org/article/S2772-9303(24)01740-X/fulltext

McLaren J, de Alencar JN, Aslanger EK, Meyers HP, Smith SW. From ST Elevation MI to Occlusion MI: the new paradigm shift in acute myocardial infarction. JACC: Advances 2024. https://www.sciencedirect.com/science/article/pii/S2772963X24005933

Avdikos G. Expertise in ECG Interpretation and Artificial Intelligence ECG Models for Occlusion Myocardial Infarction. Japan Journal of Research 2024 volume 5, Issue 10.

(Abstract)

Kisova T, Herman R, Demolder A, Bahyl J, Hybasek Dzurikova H, Smith S, Meyers H, et al. Female patients with occlusive myocardial infarction without ST elevation experience longer delays in receiving emergent reperfusion [abstract]. Circulation. 2024;150(Suppl_1). Available from: https://doi.org/10.1161/circ.150.suppl_1.4140044

(Abstract)

Herman R, Lauwers R, Pletnickx D, Meyers H, Smith S, Kisova T, et al. Deep-learning assisted ECG-based emergent cathlab activation: first prospective implementation of a smartphone-based system [abstract]. Circulation. 2024;150(Suppl_1). Available from: https://doi.org/10.1161/circ.150.suppl_1.4139994

(Abstract)

Choi J, Torelli V, Diaz S, Vaish E, Katic L, Nagourney A, Khan Z, Silverman A, Farhan S. AI-enhanced recognition of occlusion in acute coronary syndrome (AERO-ACS): a retrospective review [abstract]. Circulation. 2024;150(Suppl_1). Available from: https://doi.org/10.1161/circ.150.suppl_1.4144910

(Abstract)

Harris S, Brown F, May A, Bach R. Artificial intelligence tool accurately predicts occlusion myocardial infarction and may reduce false-positive cath lab activations [abstract]. Circulation. 2024;150(Suppl_1). Available from: https://doi.org/10.1161/circ.150.suppl_1.4144603

Bradshaw JC, Nagourney E, Warshel M, Weygandt PL. Implementing artificial intelligence for electrocardiogram interpretation: A case study. JEM Reports. 2024. https://www.sciencedirect.com/science/article/pii/S2773232024000622

Important Media 2024, all reviewing this article from JACC Advances:

Smith SW. Parallax Podcast with Ankur Kalra, October 21, 2024: Ep 121: OMI/NOMI: A Paradigm Shift in Myocardial Infarction Diagnosis With Dr Stephen Smith

This Week in Cardiology Podcast, on Medscape, with John Mandrola: OMI NOMI starts at 6:30, October 11, 2024.

Harrington RA. Patel MR. Gibson CM. The Bob Harrington Show on Medscape. Does ST Elevation MI Need a Rebrand to 'Occlusion MI'. December 10, 2024.

2025

Herman R, Kisova T, Belmonte M, Wilgenhof A, Toth G, Demolder A, Rafajdus A, Meyers HP, Smith SW, Bartunek J, Barbato E. Artificial intelligence-powered electrocardiogram detecting culprit vessel blood flow abnormality: AI-ECG TIMI study design and rationale. JSCAI 2025. https://www.jscai.org/article/S2772-9303(24)02183-5/fulltext

Ricci F, Martini C, Scordo DM, Rossi D, Gallina S, Fedorowski A, Sciarra L, Chahal AA, Meyers HP, Herman R, Smith SW. ECG patterns of occlusion myocardial infarction: A narrative review. Annals of EM, 2024. https://doi.org/10.1016/j.annemergmed.2024.11.019

Herman R, Smith SW. The crucial role of image quality in AI-enabled ECG digitization and interpretation of occlusion myocardial infarction. J Electrocardiol [Internet] 2025 [cited 2025 Jan 13];153873. Available from: https://scholar.google.com/citations?view_op=view_citation&hl=en&citation_for_view=ZBKuiKwAAAAJ:7LPp1NROPxwC

McLaren JTT, Alencar JN, Aslanger EK, Meyers HP, Smith SW. Reply: Occlusion myocardial infarction: from theoretical concept to practical therapy. Letter to the Editor. JACC Advances, 2015. https://doi.org/10.1016/j.jacadv.2024.101550

Queen of Hearts Timeline Only:

2023

Herman R, Meyers HP, Smith SW. ECG-based deep learning for detecting epicardial coronary occlusion in acute myocardial infarction. European Heart Journal, Volume 44, Issue Supplement_2, November 2023, ehad655.2930. https://doi.org/10.1093/eurheartj/ehad655.2930

Herman, Meyers, Smith, et al. International Evaluation of an Artificial Intelligence-Powered Electrocardiogram Model Detecting Acute Coronary Occlusion Myocardial Infarction. EHJ DH. 2023.

https://doi.org/10.1093/ehjdh/ztad074

2024

(Abstract)

https://www.heartrhythmjournal.com/article/S1547-5271%2824%2901176-7/fulltext

https://hqmeded-ecg.blogspot.com/2024/09/single-center-retrospective-validation.html

(Abstract)

(Link pending)

(Abstract)

2025

Herman R, Kisova T, Belmonte M, Wilgenhof A, Toth G, Demolder A, Rafajdus A, Meyers HP, Smith SW, Bartunek J, Barbato E. Artificial intelligence-powered electrocardiogram detecting culprit vessel blood flow abnormality: AI-ECG TIMI study design and rationale. JSCAI 2025. https://www.jscai.org/article/S2772-9303(24)02183-5/fulltext

Submitted abstract:

Nystrom and Lindow. Validation of an artificial intelligence electrocardiogram model for detection of acute coronary occlusion myocardial infarction in Swedish emergency departments.

Macherey-Meyer S. Meyers HP. Smith SW. et al. Artificial intelligence – based detection of occlusion myocardial infarction: first external validation in a German chest pain unit court.

OMI Literature Timeline

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