Electrocardiographic Profile of Dilated Cardiomyopathy in Patients Attending a Tertiary Care Hospital of Western Nepal

Abstract

INTRODUCTION: Cardiomyopathy is a disease of the heart muscle that leads to deterioration of myocardial functioning. It has different morphological variation with dilated cardiomyopathy being the most common form comprising over 90% of all cases. Heart failure (HF) is the most common clinical presentation of dilated cardiomyopathy. Various electrocardiographic changes are common in these patients. The most common cause of sudden death in these patients is arrhythmia. This study aimed at characterizing different electrocardiographic changes in patients of dilated cardiomyopathy admitted for heart failure.MATERIAL AND METHODS: A retrospective analysis of records of admitted patients from l" January 2015 to 30th April 2018 was conducted. Study was conducted after obtaining ethical clearance from institutional review board. Data was collected in a preformed proforma and analyzed using SPSS 20.0 version.RESULTS: Consecutive 400 cases of dilated cardiomyopathy with systolic dysfunction (LVEF<40%) were taken for the study. Two hundred and fifty two (63 %) were male. The mean age of patients was 59.33 (± 15.76) years. The most common risk factors in our patients were smoking (66%) followed by systemic hypertension (49%), IHD (32%), and diabetes mellitus (33%) respectively. Out of 400 patients, abnormal ECG were found in 82.5%. The most common abnormality was LVH (30.7%) followed by LBBB (22.5%) and AF (20.5%).CONCLUSION: The percentage of abnormal electrocardiographic findings was high in our study. All patients of dilated cardiomyopathy should undergo electrocardiography screening for risk stratification and to prevent serious consequences with early necessary intervention.Journal of Universal College of Medical SciencesVol. 6, No. 1, 2018, Page: 40-45

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

“…They covered several different geographical regions including American, Europe and Asia. The specific countries included were China [43], Germany [6][7][8]29], India [9,[11][12][13], Italy [5,15,27,28,[31][32][33], Japan [41], Nepal [10], Netherlands [24,25], Norway [36], Spain [18], Sweden [42]. Switzerland [22], U.K. [14,16,17,23,44], U.S. [14,[19][20][21]26,30,34,35,[37][38][39][40].…”

“…The included studies also adopted difference research designs of which a greater number of studies (n=29; 72.5%) were prospective cohort studies [5][6][7][8][9]13,[15][16][17][18][19][20][21][22][23][24][25][28][29][30][31][32][33][34][36][37][38]42,44]. The remaining studies were retrospective cohort (n=9; 22.5%) [10,14,26,27,35,39,40,41,43] and cross-sectional studies (n=2; 5%) [11,12]. In addition to study design, most of the studies were non-randomized and non-blinded because the primary aim of this study was to determine the prevalence and types of arrhythmias among CM patients.…”

“…These were DCM, HCM, RCM, ARVC, and LVNC. Of these five structural forms of CM, the most studied was ARVC evaluated by ten studies (25%) [27][28][29][30][31][32][33][34][35][36], followed by DCM evaluated by nine studies (23%) [5][6][7][8][9][10][11][12][13], RCM by eight studies (20%) [37][38][39][40][41][42][43][44], HCM by seven studies (18%) [14][15][16][17][18][19][20] and LVNC by six studies (15%) (Table 1). In total, the 40 studies had a population size of 6,601 patients diagnosed with four structural types of CM (DCM, HCM, RCM, ARVC, and LVNC).…”

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

“…They covered several different geographical regions including American, Europe and Asia. The specific countries included were China [43], Germany [6][7][8]29], India [9,[11][12][13], Italy [5,15,27,28,[31][32][33], Japan [41], Nepal [10], Netherlands [24,25], Norway [36], Spain [18], Sweden [42]. Switzerland [22], U.K. [14,16,17,23,44], U.S. [14,[19][20][21]26,30,34,35,[37][38][39][40].…”

“…The included studies also adopted difference research designs of which a greater number of studies (n=29; 72.5%) were prospective cohort studies [5][6][7][8][9]13,[15][16][17][18][19][20][21][22][23][24][25][28][29][30][31][32][33][34][36][37][38]42,44]. The remaining studies were retrospective cohort (n=9; 22.5%) [10,14,26,27,35,39,40,41,43] and cross-sectional studies (n=2; 5%) [11,12]. In addition to study design, most of the studies were non-randomized and non-blinded because the primary aim of this study was to determine the prevalence and types of arrhythmias among CM patients.…”