ECG as a screening tool: Difference between revisions
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# frequent atrial or ventricular premature beats | # frequent atrial or ventricular premature beats | ||
# fascicular blocks | # fascicular blocks | ||
==ECG markers of increased risk of ventricular arrhythmias in ICD patients== | |||
In a recent study several ECG risk markers were found to be associated with appropiate therapy in ICD patients<cite>Shi</cite>: | |||
* depressed heart rate variability (HRV) [HR 2.7] | |||
* BBB with large QRS dispersion of > 39 msec (difference between maximal and minimum QRS across 12 leads) [HR 2.9] | |||
* Reduced maximal T wave amplitude (<0.4 msec in patients without BBB) [HR 3.8] | |||
* History of atrial arrhythmias [HR 2.3] | |||
==References== | ==References== | ||
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#novacode pmid=9682893 | #novacode pmid=9682893 | ||
#Denes pmid=17341712 | #Denes pmid=17341712 | ||
#Shi pmid=23118007 | |||
</biblio> | </biblio> | ||
Revision as of 22:06, 8 September 2013
A recent study among asymptomatic post-menopausal women found an adjusted hazard ratios for CHD events of 1.55 (95% CI, 1.14-2.11) for minor, 3.01 (95% CI, 2.03-4.46) for major ECG abnormalities.[1] This study used a well defined list of major and minor ECG abnormalities that can be used to get a feel for major and minor ECG abnormalities:
Major ECG abnormalities[1][2]:
- atrial fibrillation or atrial flutter
- high-degree atrioventricular dissociation
- left bundle-branch block
- right bundle-branch block
- indeterminate conduction delay
- Q-wave MI
- isolated ischemic abnormalities
- left ventricular hypertrophy with ST-T abnormalities
- supraventricular tachycardia
- ventricular preexcitation
- ventricular tachycardia
Minor ECG abnormalities[1][2]:
- first- and second-degree atrioventricular block
- borderline prolonged ventricular excitation
- prolonged ventricular repolarization
- isolated minor Q and ST-T abnormalities
- left ventricular hypertrophy without ST-T abnormalities
- left atrial enlargement
- frequent atrial or ventricular premature beats
- fascicular blocks
ECG markers of increased risk of ventricular arrhythmias in ICD patients
In a recent study several ECG risk markers were found to be associated with appropiate therapy in ICD patients[3]:
- depressed heart rate variability (HRV) [HR 2.7]
- BBB with large QRS dispersion of > 39 msec (difference between maximal and minimum QRS across 12 leads) [HR 2.9]
- Reduced maximal T wave amplitude (<0.4 msec in patients without BBB) [HR 3.8]
- History of atrial arrhythmias [HR 2.3]
References
- Denes P, Larson JC, Lloyd-Jones DM, Prineas RJ, and Greenland P. Major and minor ECG abnormalities in asymptomatic women and risk of cardiovascular events and mortality. JAMA. 2007 Mar 7;297(9):978-85. DOI:10.1001/jama.297.9.978 |
- Rautaharju PM, Park LP, Chaitman BR, Rautaharju F, and Zhang ZM. The Novacode criteria for classification of ECG abnormalities and their clinically significant progression and regression. J Electrocardiol. 1998 Jul;31(3):157-87.
- Shi B, Harding SA, Jimenez A, and Larsen PD. Standard 12-lead electrocardiography measures predictive of increased appropriate therapy in implantable cardioverter defibrillator recipients. Europace. 2013 Jun;15(6):892-8. DOI:10.1093/europace/eus360 |