DIAGNOSTIC ACCURACY OF PROLONGED QRS COMPLEXES > 140MS ON ECG AS A PREDICTOR OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION KEEP ECHOCARDIOGRAPHY AS A GOLD STANDARD
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Keywords
QRS duration, left ventricular systolic dysfunction, electrocardiography, echocardiography, diagnostic accuracy
Abstract
Objective: This study aimed to evaluate the diagnostic accuracy of prolonged QRS duration (>140 ms) on electrocardiography (ECG) as a predictor of left ventricular systolic dysfunction (LVSD) in patients, using echocardiography as the gold standard for diagnosis.
Methodology: We assessed 120 patients aged 40 years and above. The patients were selected based on clinical suspicion of LVSD, and those with known valvular heart disease, significant arrhythmias, or previous interventions such as pacemakers were excluded. Each participant underwent a 12-lead ECG to measure QRS duration and an echocardiographic assessment to determine left ventricular ejection fraction (LVEF), with LVSD defined as LVEF < 50%. Prolonged QRS duration (>140 ms) was categorized as a positive criterion for predicting LVSD.
Results: Of the 120 participants, prolonged QRS duration (>140 ms) demonstrated sensitivity 78.8%, specificity 70.4% and diagnostic accuracy diagnostic accuracy 75.0% for predicting LVSD.
Conclusion: Prolonged QRS duration (>140 ms) on ECG can be considered a useful screening tool for identifying LVSD, although its specificity is moderate.
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Dr Sulaiman khan
Trainee registrar, Cardiology Department of MTI-Mardan Medical Complex, Mardan
Dr Latif Ullah
Post Graduate Resident, Cardiology Department of Saidu Group of Teaching Hospitals, Swat
Dr Muhammad Waseem Hussain
Post Graduate Resident, Cardiology Department of Khyber Teaching Hospital, Peshawar