Abstract
Background: Electrocardiographic findings of atrial septal defects (ASD) include right bundle branch blocks (RBBB), isolated negative T-waves, discontinuous T-waves in the chest leads, and a notch in the inferior limb leads (crochetage pattern). The aim of the present study was to determine the usefulness of a crochetage pattern for indicating the presence of ASD.
Method: We retrospectively reviewed the electrocardiograms of (1) 59 patients with ASD who underwent catheterization between 2002 and 2012 and (2) 60 subjects who showed RBBB in school heart examination from 2007 to 2012.
Results: (1) Electrocardiograms of the patients with ASD indicated a crochetage pattern in 41 cases. There was no significant difference in the pulmonary-to-systemic blood flow ratio (Qp/Qs) and the right ventricular end diastolic volume between the patients with the crochetage pattern and those without it. Preschool children had lower positive rates of the crochetage pattern than all other age groups.(2) ASD was detected in 10 of 60 subjects. A finding of a crochetage pattern with RBBB was highly sensitive for detection of ASD, while a finding of discontinuous T-waves with RBBB was highly specific.
Conclusion: A finding of a crochetage pattern and discontinuous T-waves in combination with RBBB may enable the highly accurate detection of ASD.
