Winning hearts and minds: ECG reporting in the first seizure clinic

Huang, X., Malek, N., Simpson, J., Kalladka, D., Dunn, F. G. and Leach, J. P. (2021) Winning hearts and minds: ECG reporting in the first seizure clinic. BMC Cardiovascular Disorders, 21, 364. (doi: 10.1186/s12872-021-02174-4) (PMID:34332536) (PMCID:PMC8325235)

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Abstract

Background and aims: An electrocardiogram (ECG) is a mandatory test for anyone presenting with loss of consciousness. Many referrals to the first seizure clinic (FSC) are caused by syncope. We assessed the sensitivity of neurologists’ ECG reporting in detecting rhythm abnormalities including some potentially life-threatening cardiac conditions. Methods: We audited patients referred to a FSC in Glasgow over 4 years. All ECGs were interpreted by the attending neurologist as standard practice. Subsequently, two cardiologists reviewed the ECGs independently. Results: Of 160 consecutive patients, 92 patients (58%) were diagnosed as having seizures, 43 (27%) as syncope, and 25 (16%) were unclassified. Twenty eight ECGs thought to be normal by the neurologist were considered abnormal by the cardiologist, including three with long corrected QT interval. The proportion of abnormal ECGs and disparity in reporting between neurologists and cardiologists persisted independent of the underlying diagnosis. Conclusion: Reporting of ECGs by non-cardiologists may not be adequately sensitive in picking up potentially life threatening cardiac conditions. Cardiologist input into FSCs is recommended to enhance the diagnostic yield.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Leach, Dr John Paul and Huang, Dr Xuya and Kalladka, Dr Dheeraj
Authors: Huang, X., Malek, N., Simpson, J., Kalladka, D., Dunn, F. G., and Leach, J. P.
College/School:College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:BMC Cardiovascular Disorders
Publisher:BioMed Central
ISSN:1471-2261
ISSN (Online):1471-2261
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BMC Cardiovascular Disorders 21: 364
Publisher Policy:Reproduced under a Creative Commons License

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