Defective T wave combined with incomplete right bundle branch block： a new electrocardiographic index for diagnosing atrial septal defect

• Published in: Chinese medical journal Vol. 125; no. 6; pp. 1057 - 1062
• Main Authors: Wang, Mu-xuan, Wu, Gui-fu, Gu, Jing-li, Li, Li, Lu, Kun, Yang, Da, Chen, Long, Zhang, Xi, Luo, Fu-tian, Michaels, Andrew D, Ma, Hong
• Format: Journal Article
• Language: English
• Published: China Department of Cardiovascular Disease, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China%Faculty of Medical Statistics and Epidemiology, School of Public Health of Sun Yat-sen University, Guangzhou, Guangdong 510080,China%Division of Cardiology, University of Utah, Salt Lake City, UT,USA 01.03.2012
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bundle-Branch Block - diagnosis; Bundle-Branch Block - physiopathology; Child; Child, Preschool; Electrocardiography; Female; Heart Septal Defects, Atrial - diagnosis; Humans; Male; Middle Aged; Predictive Value of Tests; Sensitivity and Specificity; 不完全性; 传导阻滞; 合并; 心电图; 房间; 缺损; 缺陷; 诊断测试; diagnosis; T wave; atrial septal defect; bundle branch block; electrocardiography
• ISSN: 0366-6999; 2542-5641; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2012.06.018

Background Incomplete right bundle branch block （ICRBBB） is commonly associated with atrial septal defect （ASD）, but lacks sufficient diagnostic test characteristics. An abnormal T wave is also often observed in ASD, with horizontal or inverted displacement of the proximal T wave limb in the right precordial leads, termed ＂defective T wave＂ （DTW）. Methods We examined the diagnostic test characteristics of combining ICRBBB with DTW as a new index to diagnose ASD. A total of 132 consecutive patients with ASD and 132 cases of age/gender-matched controls without ASD were enrolled. Results Sensitivities of DTW, ICRBBB, and both were 87.1%-87.9%. Specificities were 97.0%, 96.2%, and 100%, respectively. Positive predictive values were 1.3%, 1.1%, and 100.0% respectively, while negative predictive values were 99.9% for each. Conclusion Combining ICRBBB with DTW in electrocardiogram （ECG） as a new index significantly increased the specificity and positive predictive values while maintaining a high sensitivity in diagnosing ASD.