A meta-analysis of ECG abnormalities (arrhythmia) in cardiomyopathies

Abstract

The ECG is an important initial test for patients suspected with CM. The greater majority of patients who meet the diagnostic criteria of the primary structural and functional forms of CM -DCM, HCM, RCM, LVNC, and ARVC usually present with ECG abnormalities. ECG tests are the mainstay for the detection of arrhythmias, which are frequent manifestations of cardiac involvement, and they portend poor prognosis and complicate clinical management. The most studied arrhythmias among CM patients are AF, VT and extrasystoles. The overall prevalence of AF was 12.8%. The highest prevalence was in RCM patients (19.2%) followed by DCM (15.2%), HCM (8.0%), LVNC (7.7%), and the least was in ARVC patients (3.3%). The prevalence of VT was 38.0%, which was highest in ARVC (55.1%), followed by DCM (32.4%), HCM (22.9%), LVNC (20.2%), RCM (10.1%). Extrasystoles, specifically PVC had a prevalence of 56.6%. DCM had the highest prevalence (79.2%), ARVC (41.8%), RCM (56.6%), the one study investigating 177 HCM patients reported 136 had PVCs. ECG-assessed VTS or PVCs is an important diagnostic tests to differentiated VTSs due to ARVD and those due to RVOT. In conclusion, ECG is a valuable test for AF, VT and PVC, which are prevalent and can inform the administration of the most appropriate therapy.