Ruiz-Mateos B, García-Borbolla R, Nunez-Gil I, et al. - Since the management of inferior infarction with ST-segment elevation myocardial infarction can be assisted by the recognition of the culprit artery and suboptimal efficacy of earlier published algorithms meant to aid the detection of the infarct-related artery has been suggested in some studies, therefore, researchers intended to construct a better method to localize the culprit artery based on 12-lead ECG. Two different cohorts of patients with inferior ST-segment elevation myocardial infarction, ie, derivation cohort with 252 patients and validation cohort with 90 patients, were analyzed for ECG and coronary angiograms. The algorithm developed was as follows: (ST-elevation in III + aVF + V3) − (ST-elevation in II + V6) less than 0.75 mm means that the culprit artery is the left circumflex artery (Cx). The culprit artery is the right coronary artery if the result is at least 0.75. To localize the culprit artery, the best algorithm included ST-elevation in leads II and V6 related to Cx, and ST-elevation in leads III, aVF and V3 associated with right coronary artery. The algorithm developed by the experts has obtained internal and external validation in this study and performed better compared with other earlier published algorithms.