Cardiac conduction abnormalities in endocarditis defined by the Duke criteria

• 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
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1067/mhj.2001.116964

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