Abstract 20530: Do Screening Electrocardiograms in a Tertiary Bariatric Program Alter Patient Management? A Retrospective Cohort Study
Background: In tertiary bariatric programs, screening ECGs are routinely conducted.
Objectives: To document common ECG changes in this population and evaluate whether screening ECGs delay or alter management.
Methods: Screening ECGs of consecutive patients enrolled in a tertiary bariatric program were analyzed for baseline ECG abnormalities. The primary outcome was the incidence of ”subsequent” cardiac diagnostic testing as a result of abnormal ECGs ( including echocardiogram, stress tests, CT, MRI, holter and coronary angiograms). Test results were further reviewed to determine whether it would delay or alter management.
Results: Over 3 years, 538 consecutive patients had screening ECGs: 399 ECGs (74.1%) had at least 1 abnormality. In patients with abnormalities, 29 (7.3%) had subsequent cardiac testing. Prevalent findings include: q waves 243 patients (45.2%), inverted T-waves 165 (30.7%), bundle branch block 105 (19.6%), and poor R wave progression 75 (13.9%). On univariate analysis, findings associated with subsequent testing included: arrhythmias, heart block, axis deviation and QRS>120ms, p<0.001, p= 0.002, p=0.015 and p=0.047 respectively; ECG findings suggestive of ischemia or structural abnormalities were not associated with subsequent testing. Prevalence of abnormal ECG findings as divided by those with and without documented prior cardiac history are shown (Table 1). Only 1 patient (0.19%) among the cohort had an abnormality on subsequent testing which resulted in alteration in their bariatic care.
Conclusions: Routine screening ECGs in patients enrolled in a tertiary bariatric program demonstrated a high prevalence of abnormal findings and resulted in a high incidence of subsequent cardiac testing. Despite the high burden of ECG findings, abnormalities in subsequent
cardiac testing leading to alterations in bariatric care was rare; accordingly, the routine use of screening ECGs in this population should be questioned.
Author Disclosures: D. Goubran: None. T. James: None. A. Chong: None. B. Hibbert: None. R. Dent: None. J. Shiau: None. D.Y. So: Research Grant; Modest; Eli-Lilly Canada, Spartan Biosciences Inc, Aggredyne, USA, Roche Diagnostics. Honoraria; Modest; AstraZeneca Canada. Consultant/Advisory Board; Modest; AstraZeneca Canada.
- © 2016 by American Heart Association, Inc.