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ECG as a screening tool: Difference between revisions
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→ECG markers of increased risk of ventricular arrhythmias in ICD patients
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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.<cite>Denes</cite> 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'''<cite>Denes</cite><cite>novacode</cite>: | |||
# 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'''<cite>Denes</cite><cite>novacode</cite>: | |||
# 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<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== | ||
<biblio> | <biblio> | ||
#novacode pmid=9682893 | #novacode pmid=9682893 | ||
#Denes pmid=17341712 | |||
#Shi pmid=23118007 | |||
</biblio> | </biblio> | ||