Electrocardiographic Criteria for the Diagnosis of Right Ventricular Hypertrophy Verified at Autopsy

Lehtonen, Jari; Sutinen, S; Ikäheimo, Markku J.; Pääkkö, Paavo

doi:10.1378/chest.93.4.839

Cited by 40 publications

(26 citation statements)

References 22 publications

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“…54,55 The greatest accuracy is in congenital heart disease, with intermediate accuracy in acquired heart disease and primary pulmonary hypertension in adults. The lowest accuracy occurs in chronic lung disease.…”

Section: Right Ventricular Hypertrophymentioning

confidence: 99%

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

Hancock¹,

Deal²,

Mirvis³

et al. 2009

Circulation

291

111

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Section: Right Ventricular Hypertrophymentioning

confidence: 99%

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

Hancock¹,

Deal²,

Mirvis³

et al. 2009

Circulation

291

111

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“…S ratio. Although the proposed criteria have a good specificity between 90 and 100 percent, the sensitivity is inadequately low, ranging from 0.5 to 40 percent 4,5 .…”

Section: Introductionmentioning

confidence: 95%

Detection and Evaluation of Pulmonary Hypertension by a Synthesized Right-Sided Chest Electrocardiogram

et al. 2015

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Background: Current standard 12-lead electrocardiogram (ECG) criteria for diagnosing pulmonary hypertension (PH) have a low sensitivity. Although the right-sided chest ECG (V3R V5R) increases the diagnostic accuracy, these additional leads are not routinely recorded. The aim of the present study was to assess the usefulness of the synthesized right-sided chest ECG (Syn-ECG), generated from 12-lead ECG information, in the detection and evaluation of PH. Patients and Methods:The Syn-ECG waveforms in 30 patients with PH, defined as an estimated pulmonary arterial systolic pressure (PASP) >35 mmHg, were compared to those in 30 age-and gendermatched normal subjects. Results:The R wave amplitude and R! S ratio in the Syn-ECGs were significantly (P<0.01) greater in patients with PH than in the controls. The R wave amplitude in the Syn-ECGs exhibited a significant and better correlation (correlation coefficient 0.513 0.596, P<0.001) with the PASP than lead V1 (correlation coefficient 0.375, P=0.02). A receiver-operating characteristic curve analysis showed that the R wave amplitude (AUC 0.802, P<0.001) and R! S ratio (AUC 0.823, P<0.001) in the synthesized V5R was a good predictor of PH. New criteria, including 1) an R in V5R>0.12 mV, and 2) R! S ratio in V5R>0.42, had an improved sensitivity (0.63 and 0.73, respectively) and comparable specificity (0.93 and 0.87, respectively) to the conventional criteria (sensitivity 0.10 0.43, specificity 0.90 1.00). Conclusion:The diagnostic criteria derived from the Syn-ECG provided better diagnostic accuracy than the known conventional criteria from the standard 12-lead ECG. This technique described in the present study may be useful for diagnosing and evaluating PH. (J Nippon Med Sch 2015; 82: 136 145)

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“…Table 1 presents current criteria for RVH with their estimated prevalence in IPAH population [10,11]. Majority of data that were used to establish ECG signs of RVH, come from surgical or post-mortem studies on inhomogeneous group of patients [12][13][14][15][16][17][18][19].…”

Section: Electrocardiography In Pahmentioning

confidence: 99%

Rhythm disorders and electrocardiographic abnormalities in adult patients with pulmonary arterial hypertension (RCD code: class II)

Waligóra

Kopeć

Łach

et al. 2013

Journal of Rare Cardiovascular Diseases

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Cardiac arrhythmias may occur in the course of pulmonary hypertension as a result of structural changes related to pressure overload, myocardial hypertrophy and chamber dilation. Arrhythmias compromise greatly to clinical course of disease as they are related to clinical decline, worse outcome and prognosis. Common supraventricular arrhythmias (as atrial fibrillation or atrial flutter) are related to clinical deteriorations (in more than 80% of cases) and worse survival. Therefore early recognition and successful treatment is a key to improve outcome. This objective may be achieved by terminating arrhythmias either by (in most of cases) electrical or pharmacological cardioversion. To prevent further recurrence, radiofrequency ablation is a safe and efficient procedure. Data concerning clinical significance of ventricular arrhythmias is not well described. Most common rhythm disorders that occur during cardiorespiratory arrest are as follows: bradycardia, pulseless electrical activity and asystole, while ventricular fibrillation is a rare finding. Chances for successful resuscitation are poor, and prognosis is unfavorable, as 80% of cardiopulmonary resuscitation are unsuccessful and only 6% of patients after cardiac arrest will end up without neurological defects. The article contains also data concerning usefulness of routine electrocardiography in establishing a diagnosis of pulmonary hypertension, assessment of right ventricular hypertrophy and right ventricular overload. JRCD 2013; 1 (5): 4-7

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Electrocardiographic Criteria for the Diagnosis of Right Ventricular Hypertrophy Verified at Autopsy

Cited by 40 publications

References 22 publications

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

Detection and Evaluation of Pulmonary Hypertension by a Synthesized Right-Sided Chest Electrocardiogram

Rhythm disorders and electrocardiographic abnormalities in adult patients with pulmonary arterial hypertension (RCD code: class II)

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