COMPARISON OF SENSITIVITY AND SPECIFICITY OF DIFFERENT STANDARD ECG CRITERIA FOR DIAGNOSING LEFT VENTRICULAR HYPERTROPHY

Yennam Naresh; Nikhil Rajendra Arve; Rakesh Keshari Swain; Sobhitendu Kabi

Volume : X, Issue : V, May - 2020

COMPARISON OF SENSITIVITY AND SPECIFICITY OF DIFFERENT STANDARD ECG CRITERIA FOR DIAGNOSING LEFT VENTRICULAR HYPERTROPHY

Yennam Naresh, Nikhil Rajendra Arve, Rakesh Keshari Swain, Sobhitendu Kabi

Abstract :

Electrocardiography (ECG) has become the most common and the first investigation in case of any clinical suspicion of heart disease. The very next investigation is evaluation by echocardiography (ECHO/ Doppler). The ECHO/Doppler study not being readily accessible everywhere, effort has always been done to make the most out of ECG. One of the most important tool for diagnosis of left ventricular hypertrophy (LVH) is ECG. Nonetheless the sensitivity and specificity for LVH in ECG has been low. There are different methods to evaluate LVH with different levels of sensitivity and specificity. We thought of compå the different methods for detection of LVH in ECG and draw a conclusion which one is the best among the different methods. We took up the present study in IMS & SUM Hospital located in eastern costal belt of India. 100 patients admitted to medicine ward clinically suspected to have LVH were included in the study. Patients with AV block, LBBB/ RBBB and acute myocardial infarction/ ischemia were excluded from the study. The results obtained by three different ECG criteria for LVH were compared with ECHO evidence of the same. Diagnostic validity (sensitivity and specificity) and kappa measurement of agreement were performed. The study has shown that ECG evidence of LVH is the lowest when interpreted by the commonest method (S in V1 + R in V5 or V6 whichever is greater). Whereas ECG evidence of LVH is highest by tedious and time tacking method (Total QRS voltage criteria) which is least used in clinical practice.