The Value Of Crochetage On R Wave In Inferior Leads Of ECG In Diagnosing Secundum ASD

Objective:To investigate the value of Crochetage on R wave in Ⅱ、Ⅲ、aVF leads of12-lead body surface Electrocardiogram (ECG) diagnosing patients with secundum atrial septal defect (ASD).Methods:1. Selected the patients who have hospitalized in Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region and The Fifth Affiliated Hospital of Xinjiang Medical University from January2009to October2013. The patients include155cases of secundum ASD (the case group) and216cases of the control group. The control group contain6patients with ostium ASD,161patients with ventricular septal defect (VSD),14patients with pulmonary stenosis(PS),3patients with primary pulmonary hypertension (PPH),15patients with patent ductus arteriosus (PDA), and15patients with patent foramen ovale (PFO);2. Retrospectively analysis the incidence rate of right bundle branch block (RBBB) and the Crochetage pattern in Ⅱ、Ⅲ、aVF leads of ECG and calculated the relative sensitivity, specificity, positive predictive value, negative prediction value, Yuden index and the index of diagnosis about the Crochetage pattern;3.Analysis the correlation between the incidence rate of Crochetage pattern in inferior leads of ECG and the factors of age, gender, the size and area of defect, pulmonary artery pressure, PO/AO and the appearance of RBBB in155patients with secundum ASD.Results:1.The Crochetage pattern was observed in98cases in155secundum ASDs (63.23%), more than the control groups (20.83%). The high specificity of the Crochetage pattern is worthy for the diagnosis when present in^2inferior limb leads,3leads, or comparison to patient with RBBB(≥90.28%);2.1n this study, when present in≥2inferior limb leads,3leads with Crochetage pattern, the DI is the most high, and the number is142.39%,142.91%respectively;3.The patient’s age, gender, defect area, pulmonary artery pressure and PO/AO have no significant influence on the incidence rate of Crochetage pattern (p>0.01);4.The incidence rate of Crochetage pattern is related to the defect diameter (p<0.01), and the greater defect diameter, the higher incidence will be present;5.The appearance of RBBB in secundum ASDs patient has significant influence on the incidence rate of Crochetage pattern.Conclusion:It is a valuable pattern for Crochetage pattern in inferior limb leads of ECG to diagnose secundum ASD, and diagnostic value is higher which is associated with RBBB; In certain extent,the Crochetage pattern can be used for assessing the defect diameter of secundum ASD.