Prevalence Of Electrocardiogram Abnormalities Research Articles

Non-Invasive Ventilation Support during Hospitalization for SARS-CoV-2 and the Risk of Venous Thromboembolism.

Background/Objectives: Although SARS-CoV-2 infection is a significant risk factor for venous thromboembolism (VTE), data on the impact of the use of non-invasive ventilation support (NIVS) to mitigate the risk of VTE during hospitalization are scarce. Methods: Data for 1471 SARS-CoV-2 patients, hospitalized in a single hub during the first pandemic wave, were collected from clinical records, including symptom duration and type, information on lung abnormalities on chest computed tomography (CT), laboratory parameters and the use of NIVS. Determining VTE occurrence during hospital stays was the main endpoint. Results: Patients with VTE (1.8%) had an increased prevalence of obesity (26% vs. 11%), diabetes (41% vs. 21%), higher CHA2DS2VASC score (4, IQR 2-5 vs. 3, IQR 1-4, age- and sex-adjusted, p = 0.021) and cough (65% vs. 44%) and experienced significantly higher rates of NIVS (44% vs. 8%). Using a stepwise multivariate logistic regression model, the prevalence of electrocardiogram abnormalities (odds ratio (OR) 2.722, 95% confidence interval (CI) 1.039-7.133, p = 0.042), cough (OR 3.019, 95% CI 1.265-7.202, p = 0.013), CHA2DS2-VASC score > 3 (OR 3.404, 95% CI 1.362-8.513, p = 0.009) and the use of NIVS (OR 15.530, 95% CI 6.244-38.627, p < 0.001) were independently associated with a risk of VTE during hospitalization. NIVS remained an independent risk factor for VTE even after adjustment for the period of admission within the pandemic wave. Conclusions: Our study suggests that NIVS is a risk factor for VTE during hospitalization in SARS-CoV-2 patients. Future studies should assess the optimal prophylactic strategy against VTE in patients with a SARS-CoV-2 infection candidate to non-invasive ventilatory support.

#4750 PREVALENCE OF ELECTROCARDIOGRAPHIC ABNORMALITIES IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Abstract Background and Aims The presence of electrocardiogram (ECG) abnormalities is high in patients with end-stage kidney disease, but no studies have examined the prevalence of ECG abnormalities according to different strata of estimated glomerular filtration rate (eGFR) in a population-based setting. Method This was a retrospective cross-sectional study including 310,060 individuals from the Copenhagen General Practitioners' Laboratory who had an available digital ECG recorded between 2001 and 2015 and a creatinine measurement within 7 days of the ECG. eGFR was calculated using the The Chronic Kidney Disease Epidemiology Collaboration equation. ECG abnormalities were categorized as no, minor or major, as done previously [1]. Patients with both minor and major ECG abnormalities were assigned as major ECG abnormalities. The prevalence of ECG abnormalities was examined according to different strata of renal function [eGFR (ml/min/1.73 m2) &amp;gt;90, 61–90, 46–60, 31–45, 30-16 and ≤15]. Ordinal logistic regression was used to illustrate the probability of ECG abnormalities as a function of eGFR. Results The median age was 55 [IQR, 41-69] years and 46% were male. A total of 47,249 (17.9%) of the included patients had an eGFR &amp;lt;60. The prevalence of major ECG abnormalities increased with declining eGFR: &amp;gt;90 (16.5%), 61–90 (21.6%), 46–60 (36.5%) 31–45 (52.1%), 30-16 (57.9%) and ≤15 (60.1%). In ordinal logistic regression, the risk of having major ECG abnormalities compared to minor/no abnormalities significantly decreased pr. 5 ml/min increase in eGFR, OR 0.90 (95% CI, 0.85-0.90), Fig. 1. The most common major ECG abnormalities were left ventricular hypertrophy and ST-T deviations. The prevalence of all ECG abnormalities is shown in Table 1. Conclusion ECG abnormalities are common in patients with chronic kidney disease, and the probability of major ECG abnormalities increases with declining eGFR.

Prevention of Sudden Cardiac Death in Non-Competitive Athletes: ECG Screening by Telecardiology Is Useful and Cost-Effective

<i>Background: </i>Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. There are several hereditary, structural, or electrical heart diseases associated with SCD, most of them can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). <i>Objective: </i>To evaluate usefulness and cost-effectiveness of ECG screening, using a telecardiology system, in order to detect cardiovascular diseases that might cause SCD in a cohort of non-competitive athletes (NCA). <i>Methods: </i>ECGs received at the Telecardiology Center (Telemedico Srl, Genoa) for non-competitive sports, in a 3-month period were analyzed. According to the age we distinguished: NCA < 35 years (group A) and NCA > 35 years (group B). <i>Results: </i>A total of 6345 NCA (4078 males, 64.2%) were evaluated between the ages of 5 and 50 years (mean ± SD: 28.4 ± 12.6). Group A (age < 35 years) consisted of 3453 (54.4%) NCA and group B (age > 35 years) of 2892 (45.6%) respectively. An ECG pattern at risk of SCD has been identified in 295 (4.6%) subjects. Prevalence of ECG abnormalities was higher for group B (154/2892; 5.3%) than group A (141/3453; 4.1%); the difference was significant (p= 0.016). The average cost per ECG was € 12. The cost of ECG screening to identify a risk situation of SCD was € 258. <i>Conclusion: </i>ECG screening through telecardiology of NCA results to be feasible, useful and cost-effective.

Abstract 9970: Prevalence of ECG Abnormalities and Association with Arrhythmic Risk and Myocardial Fibrosis in a Large Cohort of Patients with Mitral Valve Prolapse

Background: Inverted or biphasic T-waves (IBTWs) in the inferior leads on a 12-lead electrocardiogram (ECG) have been previously described in small, retrospective samples of MVP with sudden cardiac arrest (SCA) or sudden cardiac death (SCD). However, prior studies are limited by selection of bileaflet involvement, referral bias or targeted autopsies. Moreover, the association of IBTWs with focal fibrosis remains poorly defined. Objective: To assess the rates of IBTWs and their association with arrhythmic risk and late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) in an unselected, longitudinal MVP cohort. Methods: We reviewed available 12-lead ECGs from a cohort of 570 MVP patients with clinical and ambulatory ECG or telemetry monitoring evaluated at the University of California San Francisco between 2012 and 2020. IBTWs were considered clinically relevant if present in at least 2 of 3 inferior ECG leads. Complex ventricular ectopy (ComVE) was defined as &gt;5% burden of premature ventricular contractions, bigeminy, or non-sustained ventricular tachycardia. SCD cases were identified through the National Death Index. In a subset of 86 (15%) patients with available contrast CMR, we assessed the presence and location of LGE. Results: Among 570 MVP patients (52% male, mean age 64±17), 86 (15%) had IBTWs, 160 (28%) had ComVE, and 26 (5%) had severe arrhythmic events (2 sustained VT, 13 SCA, and 11 SCD). Of these 26, 15 (58%) were bileaflet. Rates of IBTWs were similar between MVPs with severe arrhythmic events (9/26, 35%), ComVE (28/160, 18%), and no ventricular arrhythmia (58/410, 14%) ( p= 0.33). Among MVPs with contrast CMR, there were higher rates of IBTWs in those with LGE (papillary muscles or basal inferolateral wall in all) versus without LGE (7/22 vs 6/64, respectively, p = 0.01). Conclusions: In a large, unselected MVP sample inclusive of all arrhythmic presentations and leaflet subtypes, the prevalence of IBTWs is overall low and similar in those with and without ventricular arrhythmia, including SCA/SCD. In those with IBTWs, LGE in the papillary muscles or basal inferolateral wall is common, suggesting focal myocardial traction/fibrosis as the underlying anatomical substrate for repolarization abnormalities in the MVP population.

Prevalence of abnormal and borderline electrocardiogram changes in 13, 079 Chinese amateur marathon runners

BackgroundThe 12-lead electrocardiogram (ECG) has been adopted as an important component of preparticipation cardiovascular screening. However, there are still controversies in the screening and few studies with a large sample size have reported the results of ECGs of marathon runners. Therefore, the purpose of this study was to assess the prevalence of normal, borderline, and abnormal ECG changes in marathon runners.MethodsThe 12-lead ECG data of 13,079 amateur marathon runners between the ages of 18 and 35 years were included for analysis. The prevalence of ECG abnormalities among different gender groups was compared with chi-square tests.ResultsIn terms of training-related changes, sinus bradycardia, sinus arrhythmia, and left ventricular high voltage were found in approximately 15, 5, and 3.28% of the participants, respectively. The incidence of right axis deviation in the marathon runners was 1.78%, which was slightly higher than the incidence of left axis deviation (0.88%). No more than 0.1% of the amateur marathon runners exhibited ST-segment depression, T wave inversion (TWI), premature ventricular contraction, pathologic Q waves, and prolonged QT interval.ConclusionsTraining-related ECG changes, including sinus bradycardia, sinus arrhythmia, and left ventricular high voltage, were common in amateur marathon runners. Most abnormal ECG changes, including ST-segment depression, TWI, premature ventricular contraction, pathologic Q waves, and prolonged QT interval, were infrequently found in amateur marathon runners. The data also suggested Chinese amateur marathon runners may have a relatively lower prevalence of ECG abnormalities than black and white runners.

Is kratom (Mitragyna speciosa Korth.) use associated with ECG abnormalities? Electrocardiogram comparisons between regular kratom users and controls

Objectives Little is known about the cardiotoxic effects of kratom (Mitragyna speciosa Korth.), a medicinal plant. This analytical cross-sectional study investigated the prevalence of electrocardiogram (ECG) abnormalities and QTc intervals in regular kratom users compared with non-kratom-using control subjects. Methods We enrolled regular kratom users and non-kratom-using control subjects from three communities. Demographic data, clinical data, kratom use characteristics, and ECG findings were recorded. The mitragynine content of kratom juice was quantified using a validated gas chromatography–mass spectrometry (GC–MS) method. Results A total of 200 participants (100 kratom users and 100 control subjects) participated in this study. The prevalence of ECG abnormalities in kratom users (28%) did not differ from that of control subjects (32%). Kratom use was not associated with ECG abnormalities, except for significantly higher odds of sinus tachycardia (OR = 8.61, 95% CI = 1.06–70.17, p = 0.035) among kratom users compared with control subjects. The odds of observing borderline QTc intervals were significantly higher for kratom users compared with control subjects, regardless of the age of first use, the duration of use, the daily quantity consumed, and the length of time that had elapsed between last kratom use and ECG assessment. Nevertheless, there were no differences in the odds of having prolonged QTc intervals between kratom users and controls. The estimated average daily intake of mitragynine consumed by kratom users was 434.28 mg. Conclusion We found no link between regular kratom use and electrocardiographic abnormalities with an estimated average daily intake of 434.28 mg of mitragynine.

Strain pattern and T-wave alterations are predictors of mortality and poor neurologic outcome following stroke.

BackgroundStroke is associated with electrocardiogram (ECG) abnormalities. However, the role of strain pattern as predictor of poor neurologic outcome and mortality after stroke has not yet been demonstrated.HypothesisECG abnormalities, with a particular focus on ST‐segment changes, are predictors of mortality and neurologic disability 90 days after stroke.MethodsPatients with up to 24 hours of stroke were prospectively recruited. An ECG was taken at the time of admission. The patients' clinical evolution was evaluated during hospitalization and after discharge by means of a prescheduled return in 90 days. The degree of disability was measured by the modified Rankin scale (mRs). In relation to the mRs, patients were divided into those with scores from 0 to 2 and those with scores equal to or greater than 3 at the end of the observation period.ResultsOf the 112 patients studied, 29 (25.8%) died during the study period. Patients who died presented higher National Institute of Health Stroke Scale and mRs scores on admission, elevated biomarkers of myocardial necrosis, and abnormalities on the ECG. The prevalence of ECG abnormalities was 63%. A logistic regression model showed that strain pattern and T‐wave alterations were predictors of mortality (odds ratio [OR]: 12.970, 95% confidence interval [CI]: 1.519‐110.723, P = .019; OR: 3.873, 95% CI: 1.135‐13.215, P = .031, respectively) and mRs at 90 days (OR: 12.557, 95% CI: 1.671‐94.374, P = .014; OR: 15.970, 95% CI: 3.671‐69.479, P < .001, respectively) after stroke, adjusted by sex, age, stroke subtype, entrance NIH, previous mRs score, and stroke thrombolysis.ConclusionStrain pattern and T‐wave alterations were predictors of mortality and poor neurologic outcome 90 days after stroke.

Prevalence of Electrocardiogram Abnormalities in Human Immunodeficiency Virus-Infected Children

HIV is an important cause of childhood morbidity and mortality affecting more than 1.3 million children worldwide, one of the morbidity is cardiac abnormalities. Cardiovascular abnormalities are still subclinical during childhood then become symtomatic in adulthood. Electrocardiography is effective to detect cardiac diseases. This study aimed to assess ECG changes in HIV infected children and describe ECG abnormalities in HIV-infected children with or without HAART. From 70 subjects, we found the most common abnormality was sinus tachycardia in 17 patients (24.3%), sinus bradycardia 1 patient (1.4%) and 2 patients with sinus arrhythmia (2.9%). The mean QTc interval was 0.42 seconds (±0.07) and 14 patients (20%) had prolongation. The mean PR interval was 0.12 seconds (±0.02), 11 patients (15.7%) experienced prolongation of PR interval. The mean QRS duration was 0.06 seconds (±0.09). Left ventricular enlargement was present in 6 patients (8.6%), conduction disturbance which is characterized by Bundle branch block was found in 2 patients (2.9%) and ST changes was seen in 2 patients (2.9%). Other ECG abnormalities are characterized by right ventricle hyperthropy in 4 patients and a patient had T tall. The prevalence of cardiac abnormalities based on ECG examination from this study was 51.3%, consist of heart rhythm abnormality, prolonged PR interval, prolonged QTc interval, bundle branch block, ventricle hypertrophy and ST changes.

Prevalence of ECG abnormalities and risk factors for QTc interval prolongation in hospitalized psychiatric patients.

Background:Psychiatric patients are at risk of cardiovascular diseases, and many psychotropic drugs can prolong QTc interval. Requirements for electrocardiogram (ECG) monitoring have been set up in our psychiatric university hospital. The objective of this study was to determine the proportion of adult patients who had an ECG during their hospitalization, the prevalence of ECG abnormalities, the evolution of the QTc after admission, and the risk factors for QTc prolongation.Methods:Retrospective analysis of ECGs and clinical data of all patients with a complete hospitalization in 2015. Assessment of the influence of covariates on QTc using linear mixed-effects models.Results:At least one ECG (n = 600) was performed during 37.6% of the stays (n = 1198) and in 45.5% of the patients (n = 871). Among the patients with an ECG, 17.9% had significant ECG abnormalities, including 7.6% with a prolonged QTc. QTc measured at admission and during hospitalization did not change significantly (n = 46, 419.4 ± 29.7 ms, 417.2 ± 27.6 ms, p = 0.71). In the multivariate model (292 patients, 357 ECGs), the covariates significantly associated with the QTc were gender (+15.9 ms if female, p < 0.0001), age (+0.4 ms/year, p = 0.0001), triglyceride levels (+5.7 ms/mmol/l, p = 0.005), and drugs with known risk of torsades de pointes (+6.2 ms if ⩾1 drug, p = 0.028).Conclusions:The prevalence of hospitalized psychiatric patients with an abnormal ECG indicates that ECGs should be performed systematically in this population. Prescription of psychotropic drugs should be done cautiously, particularly in patients with QTc prolongation risk factors.

The prevalence of electrocardiogram abnormalities in professional divers.

The underwater environment presents physiological challenges for the cardiovascular, renal and pulmonary systems. Increases in external hydrostatic pressure reduce the capacity of the venous compartment and cause blood to move toward the lung. The aim of this study was to evaluate retrospectively electrocardiographic (ECG) changes in a cohort of professional divers. Between January 2009 and January 2012, 225 randomly selected professional divers, 204 male (91%) and 21 female (9%) attended our clinic for their biannual diving medical assessment. Their ECG records were evaluated retrospectively. The most common ECG abnormality observed was incomplete right bundle branch block (IRBBB) in 30 divers (13.3%). Eleven divers (4.9%) showed right QRS axis deviation (seven with IRBBB). Six divers had a sinus tachycardia; in four divers there was early repolarization; three divers had ventricular extrasystoles; one diver had ST elevation in lead V3; there was one with sinus arrhythmia and another with T-wave inversion in leads V2, V3 and aVF. These ECG changes were evaluated retrospectively by a cardiologist who made various recommendations for further review including bubble contrast echocardiography for IRBBB. No serious ECG abnormalities were identified, but IRBBB should be further investigated because of its association with persistent (patent) foramen ovale. Rapid cardiological review of ECGs could be achieved using modern communications technology, such as telecardiography, and further clinical investigations directed by specialist recommendation arranged promptly if indicated.

Prevalence of electrocardiographic abnormalities in young, elite Japanese athletes.

The question as to whether or not electrocardiogram (ECG) evaluations should be performed in all athletes is still controversial. So, in this study, the prevalence of electrocardiographic abnormalities was evaluated in young, elite Japanese athletes. Subjects included 174 male and 101 female Japanese athletes (mean age, 21.5 years). Sports activities included baseball, basketball, diving, fencing, gymnastics, judo, rhythmic gymnastics, soccer, swimming, tennis, track and field, volleyball, and water polo. A 12-lead resting ECG was recorded and evaluated. We used the criteria for distinctly abnormal ECG patterns as defined by Pelliccia et al. Subjects were divided into 2 groups on the basis of their exercise training type: an endurance training group and a static training group. Twenty six of 174 male subjects (14.9%) and 11 of 101 (10.9%) female subjects presented with abnormal ECG results. ECG abnormalities were observed much more frequently in track athletes compared to athletes of other sporting events. Field players did not present with any ECG abnormalities. Overall, the incidences of ECG abnormalities were statistically lower in the static exercise training group than in the endurance training group both in male and female. High voltage of left ventricle was observed in 114 of 175 male subjects (65.1%), and 27 of 101 female subjects (26.7%). The prevalence of ECG abnormalities in young, elite, Japanese athletes was comparable to that previously reported by both Western and Asian investigators.

The use and impact of 12-lead electrocardiograms in acute stroke patients: A systematic review

Stroke is a leading cause of mortality and disability across the globe. Emergency Medical Services assess and transport a large number of these patients in the prehospital setting. Guidelines for UK ambulance services recommend recording a 12-lead electrocardiogram in the prehospital environment, providing this does not add to significant delay in transporting the patient to hospital; however, this recommendation is not based on any evidence. A systematic review was conducted to search and synthesise the literature surrounding the use of prehospital electrocardiograms in acute stroke patients, focusing on the prevalence of abnormalities and their association with prognosis and outcome. Online databases, references from selected articles and hand searches were made to identify eligible studies. Two authors independently reviewed the studies to ensure eligibility criteria were met. Main outcomes were presence of abnormality on electrocardiogram, mortality and disability. No studies set in the prehospital environment were found by the search; therefore the eligibility criteria were widened to include hospital-based studies. A total of 18 studies were subsequently included in the review. Although the prevalence of electrocardiogram abnormalities appears common in hospitalised patients, their prognostic impact on mortality, disability and other adverse outcomes is conflicting amongst the literature. There is a lack of research surrounding the use of prehospital electrocardiogram in acute stroke patients. Future studies should be based in the prehospital environment and should investigate whether undertaking an electrocardiogram in the prehospital setting affects clinical management decisions or has an association with mortality or morbidity.

Abstract 18264: Abnormalities in the Electrocardiogram: a Meta-Analysis Comparing Chagas Disease to Other Cardiomyopathies

Introduction: Chagas Disease (CD) has been associated with a variety of abnormalities in the electrocardiogram (ECG). For epidemiologic purposes and differential diagnosis, we sought to perform a systematic review and meta-analysis of the relative frequencies of various ECG findings in patients with CD compared to a non-CD group. Hypothesis: ECG abnormalities differ significantly based on etiology of cardiomyopathy. Methods: PubMed, EMBASE, Cochrane Central and Latin American databases were searched for studies that directly compared the prevalence of ECG abnormalities in CD patients to a non-CD group. Odds-ratios were computed using a random-effects model due to anticipated heterogeneity. We further performed a subanalysis on studies that included only patients with known cardiomyopathy. Results: A total of 17 studies and 10,550 patients were included, of whom 4,192 (39.7%) had a positive serology for CD. Ten studies included only patients with known cardiomyopathy in both the control and CD groups. Table 1 reports the odds-ratios for the relative frequencies of various ECG abnormalities between groups. Conclusions: Our analysis suggests that amongst patients with cardiomyopathies, Chagas Disease etiology is significantly associated with an increased prevalence of right bundle branch block, premature ventricular complexes and permanent pacemaker implantation, whereas left bundle branch block is more prevalent among other cardiomyopathies. The combination of right bundle branch block with left anterior fascicular block had the highest odds ratio for prevalence among Chagas Disease patients.

PT021 The effects of Cilostazol on the ion Channels in rat right ventricular myocyte

Introduction: Chest pain is a common presentation in primary care. Although coronary artery disease is an infrequent etiology in this setting, it should be ruled out. In this context, the electrocardiogram (ECG) is very useful to assess patients with chest pain. Objectives: To assess the prevalence of ECG abnormalities in primary care patients with chest pain. Methods: This is an observational retrospective study. All ECGs performed by the Telehealth Network of Minas Gerais, a Brazilian public telehealth service, from January to December 2011, were analyzed. This service attends 660 cities in the state of Minas Gerais. The prevalence of ECG abnormalities was assessed. Results: During the study period, 197,101 ECGs were performed in patients with chest pain (mean age 50 19 years, 59.4% women). Hypertension was the most frequent comorbidity (26.8%). Family history of coronary artery disease was reported in 13.1%, smoking in 6.3% and diabetes in 4.6%. Regarding the ECGs, 61.7% had no abnormalities. The prevalence of abnormalities suggestive of ischemia was 4.4%: 2.5% poor R wave progression, 1.5% abnormalities suggestive of acute ischemia; 0.4% pathological Q waves. First degree atrioventricular block as observed in 1.8%, left bundle branch block in 1.6%, right bundle branch block in 2.8%, atrial fibrillation 1.7%, left ventricular or atrial hypertrophy in 6.5%, premature beats in 4.2% and nonspecific repolarization abnormalities in 17.4%. Although the percentage of patients with abnormalities suggestive of acute ischemia is low, primary care physicians should have in mind that a normal ECG does not rule out coronary artery disease, and a careful clinical assessment should be performed in all patients. Conclusion: In this study in a large sample of primary care patients with chest pain, the prevalence of exams with no abnormalities is higher than 50%, and a minority of patients has abnormalities suggestive of myocardial ischemia. Disclosure of Interest: None Declared

QT Interval Prolongation after Cardiac Surgery; An Interesting Biological Phenomenon or A Clinical Problem? Data from the Prolonqit Study

Abstract Objective: Intrinsic and extrinsic factors may combine to delay the cardiac repolarization measured as the QT interval in the 12-lead electrocardiogram (ECG). As the duration of the QT interval is widely applied as an–albeit imperfect–marker of risk for malignant arrhythmias we characterized the prevalence and consequences of iatrogenic QT prolongation in patients undergoing cardiac surgery. Design/patients/setting: We prospectively included clinical data and ECGs from 259 patients admitted to the intensive care unit following cardiac surgery. Main results: Prolonged QT interval is common in patients undergoing cardiac surgery; 18% of patients displayed a QTc interval longer than 500 ms in the immediate postoperative period. The majority of these patients also showed QTc prolongation before surgery, however, the QTc interval was additionally prolonged following surgery. Drugs that prolong the QT interval were commonly used. The number of these drugs used in combination correlated with the prolongation of the QTc interval. QTc duration was not prolonged in patients with reduced left ventricular ejection fraction or renal function or in patients with atrial or ventricular arrhythmias or death. Conclusions: An increased QT interval is a common finding amongst cardiothoracic surgery patients and it correlates to the administration of drugs with QT prolonging effects in the immediate postoperative period. We could not prove a correlation between the observed QT prolongation and adverse outcomes. However, the high prevalence of ECG abnormalities corresponding to the use of certain drugs calls for caution if treatment is continued especially when intensive care and monitoring is terminated.

Frequent electrocardiographic abnormalities and associated conditions in Chagas disease patients

Purpose: Chagas disease (ChD) is endemic in Latin American countries, but has become a worldwide problem due to migration of infected individuals to developed countries, mostly in Europe and North America. Electrocardiography has been considered an essential exam to evaluate ChD patients. The objective of this study was to identify prevalent abnormalities in the electrocardiogram (ECG) and common associated conditions in patients with ChD. Methods: In this observational and retrospective study, all 12-lead standard digital electrocardiograms (ECGs) analyzed by cardiologists of a public telemedicine service in Brazil, from January to December 2011 were assessed. This service attends primary care of 658 cities in Minas Gerais province. ECGs were sent by remote professionals through internet to be analyzed by cardiologists who are trained and experienced in the analysis and interpretation of ECG. The prevalence of ECG abnormalities in patients who declared to have ChD was assessed. Results: During the study period, 264,324 patients were evaluated; 7590 were ChD patients (mean age 57.0±13.7 years, 64.1% women. Hypertension was the most frequent comorbidity, present in 61.3% of the ChD patients, followed by diabetes (9.1%) and dyslipidemia (6.9%). Family history of coronary disease was reported by 32.6% of the patients, and 10.7% referred smoking. Only 30.1% of the patients had normal ECGs. Regarding the rhythm, 86.9% of them had a normal sinus rhythm, 5.3% atrial fibrillation or flutter, 5.4% ventricular premature beats, 2.5% supraventricular premature beats and 3.5% were pacemaker users. Right bundle branch block (RBBB) was observed in 22.7% of the ECGs, left bundle block in 3.1% and left anterior hemiblock (LAH) in 22.5%.The presence of first degree atrioventricular block was found in 4.9%, second and third degrees in 0.2% each. There was electrocardiographic evidence of left ventricular and atrial hypertrophy in 3.6% and 2.5% of patients, respectively. Conclusion: In this large sample of primary care patients with ChD, there was a high prevalence of ECG abnormalities. As expected, the most common abnormalities were RBBB and LAH.

Frequent electrocardiographic abnormalities and associated conditions in Chagas disease patients

Introduction: Chagas disease (ChD) is endemic in Latin American countries, but has become a worldwide problem due to migration of infected individuals to developed countries. Electrocardiography has been considered an essential exam to evaluate ChD patients. The objective of this study is to identify prevalent abnormalities in the electrocardiogram (ECG) and common associated conditions in patients with ChD. Methods: In this observational and retrospective study, all 12-lead standard digital ECGs analyzed by cardiologists of a public telemedicine service in Brazil, from January to December 2011 were assessed. This service attends primary care of 660 cities in Minas Gerais province. ECGs were sent by IT professionals in remote sites over the internet to be analyzed centrally by cardiologists who were trained and experienced in the analysis and interpretation of ECGs. The prevalence of ECG abnormalities in patients known to have ChD was assessed. Results: During the study period, 264,324 patients were assessed; 7590 were ChD patients (mean age 57.0 ± 13.7 years, 64.1% women). Hypertension was the most frequent comorbidity (61.3% of the ChD patients), followed by diabetes (9.1%) and dyslipidemia (6.9%). Family history of coronary disease was reported by 32.6% of the patients, and 10.7% were smokers. Only 30.1% of them had normal ECGs. Regarding the rhythm, 86.9% had normal sinus rhythm, 5.3% atrial fibrillation or flutter, 5.4% ventricular premature beats, 2.5% supraventricular premature beats and 3.5% were pacemaker users. Right bundle branch block (RBBB) was observed in 22.7% of the ECGs, left bundle block in 3.1% and left anterior hemiblock (LAH) in 22.5%.The presence of first degree atrioventricular block was found in 4.9%, second and third degrees in 0.2% each. There was electrocardiographic evidence of left ventricular and atrial hypertrophy in 3.6% and 2.5% of patients, respectively. Conclusion: In this large sample of primary care patients with ChD, there was a high prevalence of ECG abnormalities. As expected, the most common abnormalities were RBBB and LAH.

Atrial fibrillation: prevalence in primary care patients in Brazil

Introduction: Chagas disease (ChD) is endemic in Latin American countries, but has become a worldwide problem due to migration of infected individuals to developed countries. Electrocardiography has been considered an essential exam to evaluate ChD patients. The objective of this study is to identify prevalent abnormalities in the electrocardiogram (ECG) and common associated conditions in patients with ChD. Methods: In this observational and retrospective study, all 12-lead standard digital ECGs analyzed by cardiologists of a public telemedicine service in Brazil, from January to December 2011 were assessed. This service attends primary care of 660 cities in Minas Gerais province. ECGs were sent by IT professionals in remote sites over the internet to be analyzed centrally by cardiologists who were trained and experienced in the analysis and interpretation of ECGs. The prevalence of ECG abnormalities in patients known to have ChD was assessed. Results: During the study period, 264,324 patients were assessed; 7590 were ChD patients (mean age 57.0 ± 13.7 years, 64.1% women). Hypertension was the most frequent comorbidity (61.3% of the ChD patients), followed by diabetes (9.1%) and dyslipidemia (6.9%). Family history of coronary disease was reported by 32.6% of the patients, and 10.7% were smokers. Only 30.1% of them had normal ECGs. Regarding the rhythm, 86.9% had normal sinus rhythm, 5.3% atrial fibrillation or flutter, 5.4% ventricular premature beats, 2.5% supraventricular premature beats and 3.5% were pacemaker users. Right bundle branch block (RBBB) was observed in 22.7% of the ECGs, left bundle block in 3.1% and left anterior hemiblock (LAH) in 22.5%.The presence of first degree atrioventricular block was found in 4.9%, second and third degrees in 0.2% each. There was electrocardiographic evidence of left ventricular and atrial hypertrophy in 3.6% and 2.5% of patients, respectively. Conclusion: In this large sample of primary care patients with ChD, there was a high prevalence of ECG abnormalities. As expected, the most common abnormalities were RBBB and LAH.

Electrocardiographic abnormalities in elderly Chagas disease patients: a population-based study (the Bambuí study)

Introduction: Chagas disease (ChD) is endemic in Latin American countries, but has become a worldwide problem due to migration of infected individuals to developed countries. Electrocardiography has been considered an essential exam to evaluate ChD patients. The objective of this study is to identify prevalent abnormalities in the electrocardiogram (ECG) and common associated conditions in patients with ChD. Methods: In this observational and retrospective study, all 12-lead standard digital ECGs analyzed by cardiologists of a public telemedicine service in Brazil, from January to December 2011 were assessed. This service attends primary care of 660 cities in Minas Gerais province. ECGs were sent by IT professionals in remote sites over the internet to be analyzed centrally by cardiologists who were trained and experienced in the analysis and interpretation of ECGs. The prevalence of ECG abnormalities in patients known to have ChD was assessed. Results: During the study period, 264,324 patients were assessed; 7590 were ChD patients (mean age 57.0 ± 13.7 years, 64.1% women). Hypertension was the most frequent comorbidity (61.3% of the ChD patients), followed by diabetes (9.1%) and dyslipidemia (6.9%). Family history of coronary disease was reported by 32.6% of the patients, and 10.7% were smokers. Only 30.1% of them had normal ECGs. Regarding the rhythm, 86.9% had normal sinus rhythm, 5.3% atrial fibrillation or flutter, 5.4% ventricular premature beats, 2.5% supraventricular premature beats and 3.5% were pacemaker users. Right bundle branch block (RBBB) was observed in 22.7% of the ECGs, left bundle block in 3.1% and left anterior hemiblock (LAH) in 22.5%.The presence of first degree atrioventricular block was found in 4.9%, second and third degrees in 0.2% each. There was electrocardiographic evidence of left ventricular and atrial hypertrophy in 3.6% and 2.5% of patients, respectively. Conclusion: In this large sample of primary care patients with ChD, there was a high prevalence of ECG abnormalities. As expected, the most common abnormalities were RBBB and LAH.

Abstract P344: Prevalence of Conduction Abnormalities in a Systolic Heart Failure Disease Management Population by Race, Ethnicity, and Gender

While there have been several studies evaluating the prevalence of electrocardiogram (ECG) conduction abnormalities such as left bundle branch block (LBBB) and atrial fibrillation (AF) in the general population, there are none currently describing that of the Hispanic population in patients with systolic heart failure. Given the need for examining race and ethnic differences in ECG abnormalities, the primary purpose of this study is to compare the prevalence of ECG abnormalities in three systolic heart failure populations from two indigent heart failure clinics. The study examines EKG difference among three ethnic groups: Caucasians, African-Americans, and Hispanics. We also investigated ECG differences between genders. This is a cross sectional study. A total of 926 patients were enrolled in a systolic heart failure disease management program in two safety net hospitals in Florida and Louisiana. Inclusion criteria was an ejection fraction (EF) &lt; or equal to 40% by echocardiography, and ECGs which were obtained closest to the date of enrollment. Caucasian patients had more atrial fibrillation than African-American patients. Hispanics had more paced rhythm, left bundle branch block and abnormal QT intervals than Caucasian or African-American patients. A QRS interval greater than 120 milliseconds (ms) was less prevalent among African-Americans. ECG conduction abnormalities vary across race, ethnicity, and gender. Adequate medical attention should be addressed to these variations since relevant ECG findings can offer additional guidance for therapeutic interventions, as well as provide important prognostic information and potentially modify morbidity and mortality rates.