Prevalence of electrocardiographic abnormalities in heart failure patients attending Gujarat Adani institute of medical science, Kutch, Gujarat, India: a retrospective study

Vinit A. Thacker, Jayesh V. Trivedi


Background: The ECG is a non-invasive and comparatively simple bedside test to perform. It is mostly utilized cardiovascular diagnostic test, and it is performed by cardiologists and other physicians who are not cardiologists. The ECG is an essential test in the evaluation of patients with heart failure. The aim was to establish the prevalence of electrocardiogram (ECG) abnormalities with heart failure patients attending department of medicine, Gujarat Adani Institute of medical science, Bhuj, Kutch, Gujarat, India.

Methods: It was a retrospective study carried out department of medicine, Gujarat Adani Institute of medical science, Bhuj, Kutch, Gujarat, India. Simple random sampling technique was applied for medical records of 400 patients diagnosed with heart failure. The demographic, clinical, chest X-ray and 12-lead resting electrocardiographic (ECG) data of the patients were examined. Heart failure was diagnosed, by the modified Framingham criteria for the diagnosis of heart failure. Analysis was done using SPSS version 15 (SPSS Inc. Chicago, IL, USA) level of confidence interval and p value was set at 95% and 5% respectively.

Results: The ECGs were abnormal in 92 % of the patients, and normal in 8% of the patients. The main ECG abnormalities included: left ventricular hypertrophy (42.9%), left axis deviation (39.8%), left bundle branch block (19.4%), and left atrial enlargement (25.80%). Arrhythmias seen included: ventricular extrasystoles (11.8%), atrial fibrillation (9.1%), complete heart block (5.7), and ventricular tachycardia (3.9%).

Conclusions: ECG abnormalities are very frequent with heart failure patients in Bhuj, Kutch, Gujarat, India. The ECG is very helpful not merely in the analysis and etiology of heart failure but also it assists in recognizing significant complications of heart failure that might manipulate the option of treatment.


Arrhythmias, ECG, Heart failure, Kutch, Left ventricular hypertrophy

Full Text:



Mcmurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2012;33:1787-847.

The national institute for clinical excellence. Management of chronic heart failure in adults in primary and secondary care. Nice Guideline. 2003.

Davie AP, Francis CM, Caruana L, Sutherland GR, Mcmurray JJ. Assessing diagnosis in heart failure: which features are any use? QJM. 1997;90:335-9.

Mant J, Doust J, Roalfe A, Barton P, Cowie MR. Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modelling of implications of different diagnostic strategies in primary care. Health Technol Assess. 2009;13:1-207.

Davie AP, Francis CM, Love MP, Caruana L, Starkey IR. Value of the electrocardiogram in identifying heart failure due to left ventricular systolic dysfunction. BMJ. 1996;312:222.

Thomas JT, Kelly RF, Thomas SJ, Stamos TD, Albasha K. Utility of history, physical examination, electrocardiogram, and chest radiograph for differentiating normal from decreased systolic function in patients with heart failure. Am J Med. 2002;112:437-45.

Khunti K, Squire I, Abrams KR, Sutton AJ. Accuracy of a 12-lead electrocardiogram in screening patients with suspected heart failure for open access echocardiography: a systematic review and meta-analysis. Eur J Heart Fail. 2004;6:571-6.

Madias JE. Why recording of an electrocardiogram should be required in every inpatient and outpatient encounter of patients with heart failure. Pacing Clin Electrophysiol. 2011;34:963-7.

Khan NK, Goode KM, Cleland JG, Rigby AS, Freemantle N. Prevalence of ECG abnormalities in an international survey of patients with suspected or confirmed heart failure at death or discharge. Eur J Heart Fail. 2007;9:491-501.

Causes of heart failure as seen in Kumasi, Ghana. Available at Accessed on 12 June 2016.

Amoah AG, Kallen C. Aetiology of heart failure as seen from a National cardiac referral centre in Africa. Cardiology. 2003;93:11-8.

Mckee PA, Castelli WP, Mcnamara PM, Kannel WB. The natural history of congestive heart failure: the Framingham study. N Engl J Med. 1971;285:1441-6.

Scott RC. The electrocardiographic diagnosis of left ventricular hypertrophy. Am Heart J. 1960;59:154-5.

Owusu IK, Boakye YA. Prevalence and aetiology of heart failure in patient seen at a Teaching Hospital in Ghana. J Cardiovasc Dis Diagn. 2013;1:131.

Electrocardiographic left ventricular hypertrophy in patients seen with hypertensive heart failure. Available at Accessed on 18 June 2016.

Dzudie A, Choukem SP, Adam AK, Kengne AP, Gouking P. Prevalence and determinants of electrocardiographic abnormalities in sub- Saharan African individuals with type 2 diabetes. Cardiovasc J Afr. 2012;23:533-7.

Tsutsui H, Tsuchihashi M, Takeshita A. Mortality and readmission of hospitalized patients with congestive heart failure and preserved versus depressed systolic function. Am J Cardiol. 2001;88:530-3.

Roman VA, Juanatey JR, Basante P. Clinical characteristics and prognosis of hospitalised in patients with heart failure and preserved or reduced left ventricular ejection fraction. Heart. 2002;88:249-54.

Ho KK, Pinsky JL, Kannel WB, Levy D. The epidemiology of heart failure: the Framingham Study. J Am Coll Cardiol. 1993;22:6-13.

Kizer JR, Arnett DK, Bella JN. Differences in left ventricular structure between black and white hypertensive adults: the Hypertension Genetic Epidemiology Network study. Hypertension. 2004;43:1182-8.

Ike SO, Onwubere BJ. The relationship between diastolic dysfunction and level of blood pressure in Blacks. Ethn Dis. 2003;13:463-9.

Isezuo AS, Omotoso AB, Araoye MA, Carr J, Corrah T. Determinants of prognosis among black Africans with hypertensive heart failure. Afr J Med Med Sci. 2003;32:143-9.

Karaye KM, Sani MU. Factors associated with poor prognosis among patients admitted with heart failure in a Nigerian tertiary medical centre: a cross-sectional study. BMC Cardiovas Disord. 2008;8:16.

Familoni OB, Olunuga TO, Olufemi BW. A clinical study of pattern and factors affecting outcome in Nigerian patients with advanced heart failure. Cardiovasc J Afr. 2007;18:308-11.

Mathewson FA, Manfreda J, Tate RB, Cuddy TE. The University of Manitoba Follow-up Study--an investigation of cardiovascular disease with 35 years of follow-up (1948-1983). Can J Cardiol. 1987;3:378-82.

Ostor E, Schnohr P, Jensen G, Nyboe J, Hansen AT. Electrocardiographic findings and their association with mortality in the Copenhagen City Heart Study. Eur Heart J. 1981;2:317-28.

Whincup PH, Wannamethee G, Macfarlane PW, Walker M, Shaper AG. Resting electrocardiogram and risk of coronary heart disease in middle-aged British men. J Cardiovasc Risk. 1995;2:533-43.