Abstract 12096: A Simple Electrocardiogram Score Predicts Clinically Significant Cardiac Pathology in Patients With Atrial Fibrillation

IntroductionPatients with atrial fibrillation (AF) undergo evaluation for structural heart disease (SHD), usually by echocardiogram (echo). Little attention has been paid to the value of the 12-lead ECG in identifying cardiac pathology in AF patients. We tested the hypothesis that ECG parameters can be used to stratify AF patients for the risk of having clinically significant SHD.MethodsFrom 2014-2017, we reviewed consecutive patients with AF at a single VA hospital who had a 12-lead ECG and echo performed within 90 days apart. ECG was scored for the presence of pathological Q waves (1 point), intraventricular conduction defect (IVCD), i.e. left bundle branch block, right bundle branch block, or non-specific IVCD (1 point), and any ST/T abnormality not explained by IVCD (1 point). ECG score range was 0-3. Echo was assessed for clinically significant SHD, defined as left ventricular ejection fraction (LVEF) 50 mmHg (PHTN).ResultsPatients (n=303) had mean age 73.2±9.2 years; 97% male; mean CHA2DS2-VASc score 2.9±1.7. Mean time between ECG and echo was 26 days. For each unit increase in ECG score there was a 1.3-fold increase in log-odds of SHD with odds-ratio (OR) of 3.5 (CI 2.2-5.5) after adjustment for demographic and clinical variables (p