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Titolo:
A NORMAL ELECTROCARDIOGRAM PRECLUDES THE NEED FOR LEFT VENTRICULOGRAPHY IN THE ASSESSMENT OF CORONARY-ARTERY DISEASE
Autore:
KHAN MA; SINHA S; HAYTON S; FYNN S; HENDERSON RA; BENNETT DH;
Indirizzi:
UNIV MANCHESTER,SCH EPIDEMIOL & HLTH SCI,STOPFORD BLDG,OXFORD RD MANCHESTER M13 9PT LANCS ENGLAND WYTHENSHAWE HOSP,DEPT CARDIOL MANCHESTER M23 9LT LANCS ENGLAND
Titolo Testata:
HEART
fascicolo: 3, volume: 79, anno: 1998,
pagine: 262 - 267
SICI:
1355-6037(1998)79:3<262:ANEPTN>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
QRS SCORING SYSTEM; MYOCARDIAL INFARCT SIZE; HEART-FAILURE; HOSPITAL DISCHARGE; TRIAL; DYSFUNCTION; PERFORMANCE; DIAGNOSIS;
Keywords:
CARDIAC CATHETERIZATION; ELECTROCARDIOGRAM; LEFT VENTRICULAR EJECTION FRACTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
M.A. Khan et al., "A NORMAL ELECTROCARDIOGRAM PRECLUDES THE NEED FOR LEFT VENTRICULOGRAPHY IN THE ASSESSMENT OF CORONARY-ARTERY DISEASE", HEART, 79(3), 1998, pp. 262-267

Abstract

Objective-To assess whether a normal electrocardiogram can identify good left ventricular function and obviate the need for routine left ventriculography in patients undergoing cardiac catheterisation for suspected coronary artery disease. Design-A prospective study of patients undergoing cardiac catheterisation. Setting-A regional cardiac centre. Patients-The electrocardiograms, coronary angiograms, and left ventriculograms of 391 consecutive patients undergoing investigations for suspected coronary artery disease were entered into the study. Patients with arrhythmias and cardiac pathologies other than coronary artery disease were excluded. Main outcome measures-The electrocardiogram was assessed using a 29 point QRS scoring system, and classified by two cardiologists and a trainee cardiologist as normal or abnormal. Left ventricular function was assessed by digital ventriculography. Results-Thesensitivity, specificity, and negative predictive value of a QRS score of 0 (normal QRS complexes) for discriminating good left ventricularfunction (ejection fraction greater than or equal to 50%) were 92.6%,41.5%, and 97.2%, respectively. The figures for a normal electrocardiogram as assessed by a doctor were 96.3%, 40.4%, and 98.6% for cardiologist A; 96.3%, 37.4%, and 98.4% for cardiologist B; and 94.4%, 49.6%,and 98.2% for the cardiology trainee. Conclusions-If a cardiologist judges the ECG to be normal, left ventriculography is unnecessary and aformal QRS score does not improve reliability of this clinical judgment. Adopting this strategy would save pound 30-40 000 in consumables and 65-87 hours of catheter laboratory and staff time for a department catheterising 3000 patients with suspected coronary artery disease annually.

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Documento generato il 27/11/20 alle ore 13:43:22