Abstract

Evaluation of QRS voltage variability (Shora sign) as a diagnostic criteria of atrial fibrilla- tion

Author(s): Khalid Shora

To evaluate the importance of QRS voltage variability (Shora sign)

as a diagnostic criteria of atrial fibrillation as compared to the con-
ventional ECG diagnostic criteria.

Patients and Methods
* Patient selection
This case-control study will include:
- Group 1: 200 consecutive patients presented to out-patient
clinics with paroxysmal, persistent, long standing persistent or
permanent AF.
- Group 2: 200 consecutive patients presented to out-patient
clinics with any diagnosis rather than AF.
* Inclusion criteria
Patients will be enrolled in this study if they:
- Are 18 years old or older.
- Supply an informed consent.
* Exclusion criteria

Patients will be excluded from this study if they refuse to be in-
volved in the study.

* Method:
After providing informed consent, all patients will be subjected to
the following:
1) Proper history taking for the presence of cardiovascular risk
factors:
a. Smoking
b. Hypertension
c. Diabetes mellitus
d. Dyslipidemia
e. Family history.
2) Complete physical examination:
a. General examination.

b. Local cardiac examination.
3) 12 lead surface ECG and rhythm strip of lead I for 6
seconds to evaluate QRS voltage changes.

4) Transthoracic echocardiography: Echocardiographic examina-
tion will be done for all patients using a 2.5 MHz mechanical

transducer with the patient in the left lateral position from
multiple windows. The following will be evaluated:
a. Ejection fraction (EF) by M-mode.
b. LV dimensions.
c. Segmental wall motion abnormalities (SWMA) index.
d. Valvular stenosis or regurgitation.
e. Left atrium dimension.