OBJECTIVE: To assess whether a normal electrocardiogram can identify good left ventricular function and obviate the need for routine left ventriculography in @entity1 undergoing cardiac catheterization for suspected @entity453 . DESIGN: A prospective study of @entity1 undergoing cardiac catheterisation. SETTING: A regional cardiac centre. @entity1 : The electrocardiograms, coronary angiograms, and left ventriculograms of 391 consecutive @entity1 undergoing investigations for suspected @entity453 were entered into the study. @entity1 with @entity943 and cardiac pathologies other than @entity453 were excluded. MAIN OUTCOME MEASURES: The electrocardiogram was assessed using a 29 point QRS scoring system, and classified by two cardiologists and a trainee cardiologist as normal or abnormal. Left ventricular function was assessed by digital ventriculography. RESULTS: The sensitivity, specificity, and negative predictive value of a QRS score of 0 (normal QRS complexes) for discriminating good left ventricular function (ejection fraction > or = 50%) were 92.6%, 41.5%, and 97.2%, respectively. The figures for a normal electrocardiogram as assessed by a doctor were 96.3%, 40.4%, and 98.6% for cardiologist A; 96.3%, 37.4%, and 98.4% for cardiologist B; and 94.4%, 49.6%, and 98.2% for the cardiology trainee. CONCLUSIONS: If a cardiologist judges the ECG to be normal, left ventriculography is unnecessary and a formal QRS score does not improve reliability of this clinical judgment. Adopting this strategy would save 30-40,000 Pounds in consumables and 65-87 hours of catheter laboratory and staff time for a department catheterising 3000 @entity1 with suspected @entity453 annually.

A normal electrocardiogram precludes the need for left ventriculography in the assessment of XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease'] @entity943 :: ('MESH:D001145', 'Disease') :: ['arrhythmias']
@entity453 :: (MESH:D003324,Disease) :: ['coronary artery disease']
