OBJECTIVE: Assess the correlation between different ECG patterns and IHM in patients (Pts) with PE using a whole country dataset.
METHODS: Prospective multicenter registry which included Pts with acute PE hospitalized in 75 academic centers from October 2016 to November 2017. We considered the following ECG patterns: sinus tachycardia, pulmonary P waves, Q waves in DII-aVF leads, negative T waves in V1-V4, ST segment elevation in aVR and V1, atrial fibrillation or atrial flutter (AF/AF), right bundle branch block (RBBB), ST segment depression, S1Q3T3 pattern or Qr in V1. Statistical analysis was carried out using de STATA version 13.1. A value of p< 0.0.5 was considered statistically significant.
RESULTS: We included 684 Pts; mean age 63.8±16.7 years (43% male). Global IHM was 12%. The most prevalent ECG patterns were sinus tachycardia (51.7%), S1Q3T3 (24.5%), negative T waves in V1- V4 (16%), RBBB (9.9%), AF/AF (8.6%). Four ECG patterns remained statistically significant predictors of IHM on multivariate analysis: AF/AF (OR: 3.81; CI 95% 1.82-7.95, p< 0.01), pulmonary P waves (OR: 3.81; CI 95% 1.2-12, p< 0.04), RBBB (OR: 2.71; CI 95% 1.39-5.30, p< 0.01) and sinus tachycardia (OR: 2.05; CI 95% 1.18-3.54, p< 0.04).
CONCLUSIONS: We corroborate the usefulness of the ECG as a prognostic tool in acute PE. Four simple ECG patterns (AF/AF, Pulmonary P waves, RBBB and sinus tachycardia) were associated with a higher IHM and therefore should be considered for PE risk stratification.