Diagnostic Accuracy of Electrocardiography in Diagnosis of Left Atrial Enlargement Taking Echocardiography as the Gold Standard

Introduction: Atrial enlargement is a marker of increased cardiovascular events. Anatomic left atrial (LA) enlargement (LAE) is a marker of left ventricular (LV) diastolic dysfunction and is associated with an abnormal stress test in subjects with known or suspected coronary artery disease. In addition, it is a predictor for the development of atrial fibrillation, congestive heart failure, stroke, increased cardiac mortality, incidence and survival after myocardial infarction and combined cardiovascular events. Materials and Methods: The study was designed as a descriptive cross-sectional study with a duration of six months, conducted from October 2, 2021, to April 1, 2022, after the approval of the ethical committee .All patients who fulfilled the inclusion criteria and visited to NICVD, Karachi were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. All patients underwent electrocardiography and then echocardiography was done. The findings of electrocardiography and echocardiography were compared in order to evaluate diagnostic accuracy of electrocardiography. All the collected data were entered into the proforma attached at the end and used electronically for research purpose. Results: Mean ± SD of age was 62.4±12.2 years. In distribution of gender, 95 (45.5%) patients were male while 114 (54.5%) were female. Diagnostic accuracy of electrocardiography was noted as 56.46% in diagnosis of left atrial enlargement with sensitivity 55.41%, specificity 57.04% PPV 41.41% and NPV 70.00% by using echocardiography as gold standard. Conclusion: It is to be concluded that evaluating left atrial enlargement with electrocardiography did not proof helpful and comparable to echocardiography. Echocardiography should be done in each and every case to ensure adequate treatment.