Evaluation of QRS voltage variability (Shora sign) as a diagnostic criteria of atrial fibrilla- tionAuthor(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
- 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.
After providing informed consent, all patients will be subjected to
1) Proper history taking for the presence of cardiovascular risk
c. Diabetes mellitus
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.