Electrocardiographic findings associated with early clinical deterioration in acute pulmonary embolism

摘要

Abstract Objectives We sought to determine associations of early electrocardiogram (ECG) patterns with clinical deterioration (CD) within 5?days and with RV abnormality (abnlRV) by echocardiography in pulmonary embolism (PE). Methods In this prospective, multicenter study of newly confirmed PE patients, early echocardiography and initial ECG were examined. Initial ECG patterns included lead‐specific ST‐segment elevation (STE) or depression (STD), T‐wave inversion (TWI), supraventricular tachycardia (SVT), sinus tachycardia, and right bundle branch block as complete (cRBBB) or incomplete (iRBBB). We defined CD as respiratory failure, hypotension, dysrhythmia, cardiac arrest, escalated PE intervention, or death within 5?days. We calculated odds ratios (ORs) for CD and abnlRV with univariate and full multivariate models in the presence of other variables. Results Of 1676 patients, 1629 (97.2) had both ECG and GDE; 415/1676 (24.7) had CD, and 529/1629 (32.4) had abnlRV. AbnlRV had an OR for CD of 4.25 (3.35, 5.38). By univariable analysis, the absence of abnormal ECG patterns had OR for CD and abnlRV of 0.34 (0.26, 0.44; p?