Results of the European Society of Cardiology (ESC) ECG criteria of 2005 and 2010 and the Seattle ECG criteria
| N=188 | ESC 2005 | ESC 2010 | Seattle 2013 | 2005 N (%) | 2010 N (%) | Seattle N (%) |
|---|---|---|---|---|---|---|
| P-wave | ||||||
| Left atrium (LA) enlargement | Negative portion of the P-wave in lead V1 ≥0.1 mV in depth and ≥0.04 s in duration | Negative portion of the P-wave in lead V1 ≥0.1 mV in depth and ≥0.04 s in duration | Prolonged P-wave duration of >120 ms in leads I or II with negative portion of the P-wave ≥1 mm in depth and ≥40 ms in duration in lead V1 | 0 (0) | 0 (0) | 0 (0) |
| Right atrium (RA) enlargement | Peaked P-wave in leads II and III or V1 ≥0.25 mV in amplitude | Peaked P-wave in leads II and III or V1 ≥0.25 mV in amplitude | – | 19 (10) | 19 (10) | – |
| QRS complex | ||||||
| Axis | Right axis deviation (≥120°) | Right axis deviation (>110°) | – | 1 (1) | 4 (2) | – |
| Left axis deviation (−30° to −90°) | Left axis deviation (−30° to −90°) | Left axis deviation (−30° to −90°) | 0 (0) | 0 (0) | 0 (0) | |
| Voltage | R/S Standard lead (≥2 mV) | – | – | 23 (12) | – | – |
| S V1 or V2 (≥3 mV) | – | – | 36 (19) | – | – | |
| R V5 or V6 (≥3 mV) | – | – | 5 (3) | – | – | |
| Total | – | – | 50 (27) | – | – | |
| Abnormal Q-waves | Q-waves ≥0.04 s in duration or ≥25% of the height of the ensuing R-wave or QS pattern in two or more leads | Q-waves >4 mm deep in any lead except III, aVR | >3 mm in depth or >40 ms in duration in two or more leads (except for III and aVR) | 0 (0) | 0 (0) | 0 (0) |
| Bundle branch block | Right bundle branch block or left bundle branch block with QRS duration ≥120 ms | Complete bundle branch block (QRS ≥120 ms) and/or hemiblock | Left bundle branch block with QRS ≥120 ms, predominantly negative QRS complex in lead V1 (QS or rS), and upright monophasic R-wave in leads I and V6 | 0 (0) | 0 (0) | 0 (0) |
| – | IV conduction delay (>110 ms) | IV conduction delay (≥140 ms) | – | 4 (2) | 0 (0) | |
| RVH* | R/R’ V1 ≥0.5 mV and R/S ≥1 | R-V1 + S-V5 >10.5 mm | R-V1 + S-V5 >10.5 mm and right axis >120° | 14 (7) | 9 (5) | 0 (0) |
| ST segment | ||||||
| ST depression | ST segment in two or more leads | ST segment in two or more leads | ≥0.5 mm in depth in two or more leads | 0 (0) | 0 (0) | 0 (0) |
| T-wave | ||||||
| T-wave inversion/flattening | T-wave flattening or inversion in two or more leads | T-wave flattening or inversion in two or more leads | >1 mm in depth in two or more leads V2–V6, II and aVF, or I and aVL (excludes III, aVR and V1) | 9 (5) | 6 (3) | 6 (3) |
| QT interval | ||||||
| Long QT | QTc >440 ms (male) | QTc >440 ms (male) | QTc ≥470 ms (male) | 28 (15) | 28 (15) | 0 (0) |
| Short QT | – | QTc ≤360 ms | QTc ≤320 ms | – | 2 (1) | 0 (0) |
| Rhythm | ||||||
| Premature ventricular complex (PVC) | Premature ventricular beats | – | ≥2 PVCs per 10 s tracing | 0 (0) | – | 0 (0) |
| Ventricular arrhythmias | Severe ventricular arrhythmias | – | Couplets, triplets and non-sustained ventricular tachycardia | 0 (0) | – | 0 (0) |
| Atrial tachyarrhythmias | Supraventricular tachycardias, atrial flutter or atrial fibrillation | – | Supraventricular tachycardia, atrial fibrillation, atrial flutter | 0 (0) | – | 0 (0) |
| Sinus bradycardia | Heart rate ≤40/min | Heart rate ≤30/min or sinus pauses ≥3 s | Heart rate ≤30/min or sinus pauses ≥3 s | 0 (0) | 0 (0) | 0 (0) |
| Conduction | ||||||
| Ventricular pre-excitation† | PR <120 ms | PR <120 ms | PR <120 ms and delta wave and QRS >120 ms | 8 (4) | 8 (4) | 0 (0) |
| AV-block | First (PR ≥200 ms) | – | – | 5 (3) | – | – |
| Second | Second (other than Mobitz I) | Second (other than Mobitz I) | 0 (0) | 0 (0) | 0 (0) | |
| Third | Third | Third | 0 (0) | 0 (0) | 0 (0) | |
| Brugada pattern | – | High take-off and downsloping ST segment elevation followed by a negative T-wave in ≥2 leads in V1–V3 | High take-off and downsloping ST segment elevation followed by a negative T-wave in ≥2 leads in V1–V3 | – | 0 (0) | 0 (0) |
| Total abnormal ECGs | 89 (47) | 62 (32) | 6 (3) | |||
*N=187 due to missing V1 in 1 ECG.
†N=185 due to 3 ECGs not having sinus rhythm.