Electrocardiographic findings in patients with cryptogenic ischemic stroke and patent foramen ovale

Robert Belvís, Rubén Gabriel Leta, Alejandro Martínez-Domeño, Francesc Planas, Joan Martí-Fàbregas, Francesc Carreras, Dolores Cocho, Guillem Pons-Lladó, Jose Luís Martí-Vilalta, Antonio Bayés de Luna

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

Background: A characteristic electrocardiogram (ECG) pattern called crochetage has been described in patients with atrial septal defects. Nevertheless, there are discrepancies regarding its frequency in patients with patent foramen ovale (PFO). Objective: We analyzed the ECGs of patients who had cryptogenic stroke to study crochetage and other possible patterns in relation to PFO. Methods: We prospectively included consecutive patients who have had a cryptogenic stroke and are undergoing a right-to-left shunt (RLS) study with transesophageal echocardiography and simultaneous transcranial Doppler. Two blinded and independent cardiologists analyzed the ECGs for crochetage, defined as a notch near the apex of the R wave in inferior limb leads, P wave abnormalities, and right bundle branch block (RBBB). Results: We studied 104 patients whose mean age was 55.1 ± 12.7 years; 60.6% were men. PFO was detected in 40.4% of patients. Cardiologists recorded crochetage in 26.2% of patients with PFO and 14.5% of patients without PFO (P = .204) and RBBB in 19% and 8% of patients, respectively (P = .132). P wave abnormalities were also detected in 54.8% of patients with PFO and 35.5% of patients without PFO (P = .070). In patients with PFO, biphasic P waves were more frequent in small RLS (P = .006). Although higher frequencies of crochetage in small RLS and RBBB in moderate RLS were detected, these differences did not reach statistical significance (P = .067 and P = .05, respectively). Conclusion: There is no characteristic ECG pattern to identify the patients with cryptogenic stroke. © 2007 Elsevier Inc. All rights reserved.
Original languageEnglish
Pages (from-to)168-171
JournalJournal of Electrocardiology
Volume40
Issue number2
DOIs
Publication statusPublished - 1 Mar 2007

Keywords

  • Crochetage
  • Electrocardiogram
  • Patent foramen ovale
  • Right-to-left shunt
  • Stroke

Fingerprint Dive into the research topics of 'Electrocardiographic findings in patients with cryptogenic ischemic stroke and patent foramen ovale'. Together they form a unique fingerprint.

  • Cite this

    Belvís, R., Leta, R. G., Martínez-Domeño, A., Planas, F., Martí-Fàbregas, J., Carreras, F., Cocho, D., Pons-Lladó, G., Martí-Vilalta, J. L., & Bayés de Luna, A. (2007). Electrocardiographic findings in patients with cryptogenic ischemic stroke and patent foramen ovale. Journal of Electrocardiology, 40(2), 168-171. https://doi.org/10.1016/j.jelectrocard.2006.07.005