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KMID : 0381219890210030291
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Journal of RIMSK
1989 Volume.21 No. 3 p.291 ~ p.296
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Sensitivity and Specificity of Commonly Used Electrocardiographic Criteria for
Left Atrial Enlargement Determined by M-mode Echocardiography
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Abstract
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To assess the sensitivity and specificity of 5 commonly used electrocardiographic criteria for left atrial enlargement, electrocardiographic manifestations of left atrial enlargement were compared with left atrial size by echocardiography in 191 patients with sinus rhythm.
The 5 criteria studied and their respective sensitivity and specificity’s were as follows:
(1) P terminal force (depth by duration of the terminal portion of the P wave) in lead V,: more negative than -0.04 mm. sec.
sensitivity; 25.6 %, specificity; 95.4%
(2) Duration of negative phase of P wave in lead V1 > 40 m. sec. sensitivity; 59.3%, specificity; 82.2%
(3) Depth of negative phase of P wave in lead V1, ≥1 mm. sensitivity; 23.2%, specificity; 95.3%
(4) Total P wave duration? 111 m.sec in any standard lead sensitivity; 38.5%, specificity; 79.6%
(5) Notched P wave in any standard lead with inter peak duration>40 msec. sensitivity; 10.3%, specificity; 96.1%
Combining 2 or more of these criteria had higher specificity but lower sensitivity than each electrocardiographic criteria for left atrial enlargement.
In summary, the single most useful electrocardiographic criteria for left atrial enlargement was criteria (2) (Duration of negative phase of P wave in lead V1 > 40 m. sec) and combining 2 or more of the electrocardiographic criteria did not enhance diagnostic accuracy.
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