Cardiac conduction abnormalities in endocarditis defined by the Duke criteria

Background Cardiac conduction abnormalities occur in endocarditis and have been associated with infection extension and increased mortality. There have been no prospective studies of electrocardiographic (ECG) conduction changes in endocarditis. We examined the incidence of ECG changes in a large pr...

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Bibliographic Details
Published in:The American heart journal 2001-08, Vol.142 (2), p.280-285
Main Authors: Meine, Trip J., Nettles, Richard E., Anderson, Deverick J., Cabell, Christopher H., Corey, G.Ralph, Sexton, Daniel J., Wang, Andrew
Format: Article
Language:English
Subjects:
Arrhythmias, Cardiac - etiology
Bacterial diseases
Bacterial endocarditis, myocarditis and pericarditis. Bacterial diseases of the aorta, limb vessels and lymphatic vessels
Biological and medical sciences
Cohort Studies
Echocardiography
Echocardiography, Transesophageal
Electrocardiography
Endocarditis - complications
Endocarditis - mortality
Endocarditis - physiopathology
Female
Human bacterial diseases
Humans
Incidence
Infectious diseases
Male
Medical sciences
Middle Aged
North Carolina - epidemiology
Prospective Studies
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Summary:Background Cardiac conduction abnormalities occur in endocarditis and have been associated with infection extension and increased mortality. There have been no prospective studies of electrocardiographic (ECG) conduction changes in endocarditis. We examined the incidence of ECG changes in a large prospective cohort with suspected endocarditis and correlated changes with echocardiographic evidence of invasive infection and mortality. Methods One hundred thirty-seven of 1396 (10%) suspected cases of endocarditis were classified as “definite” or “possible” by the Duke criteria and had an interpretable ECG. ECG conduction changes were classified as old (pre-existing hospitalization), new (evident on admission or developed during hospitalization), or indeterminate. New or indeterminate abnormalities were considered “ECG conduction changes.” Echocardiogram results were reviewed to identify infected valves and invasive infection. Results ECG conduction changes were present in 36 of 137 (26%) patients. Patients with ECG conduction changes were more often male (69% vs 46%, P =.005) and had prosthetic valves (47% vs 23%, P
ISSN:0002-8703
1097-6744
DOI:10.1067/mhj.2001.116964