Abstract:
BACKGROUND:Accurate measurement of QRS complex duration (QRSd) remains crucial for the selection of patients for cardiac resynchronization therapy (CRT). However, assessment of QRSd on conventional surface electrocardiograms (ECG), especially when performed without computer assistance, may be challenging due to the limited accuracy of the human eye to discriminate differences in the range of 10 ms at 25 mm/s. The value and reproducibility of visual assessment of QRSd at 25 mm/s on conventional ECGs was compared to those obtained using an electrophysiology recording system (EPRS) with simultaneous 12 lead traces at 100 mm/s, which was considered the gold standard. METHODS:The ECGs of 102 consecutive patients with left ventricular dysfunction undergoing electrophysiological evaluation were collected. Two sets of measurements were obtained: 1) QRSd-25 measured on conventional 12-lead ECGs printed at 25 mm/s with standard amplification (10 mm/mV) by 4 different observers, and 2) QRSd-100 measured on simultaneous 12-lead traces at 100 mm/s and 40 mm/mV by 2 different observers using electronic callipers. RESULTS:Significant differences were observed between QRSd-100 and QRSd-25 measurements (19.3 ± 9.9 ms, range 1.0-47.5, p < 0.001). QRSd-25 showed significant inter and intra-observer variability. When categorizing individual ECGs in three QRSd-25 subgroups (<120 ms, 120-149 ms and ≥150 ms), low concordance was observed between both techniques (kappa index 0.25, p < 0.001). The sensitivity and specificity of QRSd-25 to detect QRSd-100 ≥ 150 ms was 36.6% and 100.0% respectively. CONCLUSIONS:Visual measurement of QRSd at 25 mm/s often underestimates its magnitude and presents significant inter and intraobserver variability.
journal_name
J Electrocardioljournal_title
Journal of electrocardiologyauthors
Caro-Codón J,Rey JR,Díaz Cruz J,Martínez Marín LA,García de Veas Marquéz JM,Castrejón S,Martínez Cossiani M,Rodríguez Sotelo L,López-Sendón JL,Merino JLdoi
10.1016/j.jelectrocard.2019.08.011subject
Has Abstractpub_date
2019-01-01 00:00:00pages
90-94eissn
0022-0736issn
1532-8430pii
S0022-0736(19)30488-1journal_volume
57pub_type
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journal_title:Journal of electrocardiology
pub_type: 杂志文章,随机对照试验
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abstract::The authors present a case of trifascicular block: complete right bundle branch block, tachycardia-dependent left anterior hemiblock, and bradycardia-dependent left posterior hemiblock. There is, in addition, a complicating independent AV junctional rhythm that is in most instances not affected by the conducted sinus ...
journal_title:Journal of electrocardiology
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abstract:AIM:P-wave dispersion (PD), and duration has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. The aim of this study was to investigate the PD in patients with coronary slow flow (CSF) phenomenon. METHODS:Study population included 48 patients with angiographically prove...
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doi:10.1016/s0022-0736(98)90308-9
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abstract::A 66-year-old woman with a long history of hypertension had an electrocardiogram with giant negative U waves in left precordial leads despite hypokalemia. This seems to be the first report of giant negative U waves induced by uncontrolled hypertension with hypokalemia. The occurrence of negative U waves in the presenc...
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journal_title:Journal of electrocardiology
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pub_type: 临床试验,杂志文章
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journal_title:Journal of electrocardiology
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journal_title:Journal of electrocardiology
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
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