What is the role of ECG in the workup of dilated cardiomyopathy?

Updated: Mar 02, 2021
  • Author: Vinh Q Nguyen, MD, FACC; Chief Editor: Gyanendra K Sharma, MD, FACC, FASE  more...
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An electrocardiogram (ECG) is helpful in identifying left ventricular enlargement and estimating the other chamber sizes. Atrial fibrillation or premature ventricular complexes are noted. Left ventricular hypertrophy or other chamber enlargement is observed. Conduction delay, particularly left bundle-branch block, can be observed. Varying degrees of atrioventricular block are noted.

An ECG showing atrial fibrillation increases the likelihood of heart failure. The absence of any ECG abnormality decreases the likelihood of heart failure. This is an important screening tool in differentiating ischemic heart disease from dilated cardiomyopathy.

In patients with nonischemic dilated cardiomyopathy, ischemia-like ECG findings may often be seen. When these findings are transient (ie, normalize) during the first heart failure treatments in these patients, there appears to be a higher occurrence of midterm left ventricular reverse modeling and favorable long-term outcomes. [87]

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