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Europace 2007 9(3):175-181; doi:10.1093/europace/eul182
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

ELECTROCARDIOGRAM

Attenuation of ECG voltage in cirrhotic patients

John E. Madias*

Mount Sinai School of Medicine of the New York University and the Division of Cardiology, Elmhurst Hospital Center, 79-01 Broadway, Elmhurst, NY 11373, New York, NY, USA

Two patients with cirrhosis (CIR), ascites (ASC), and peripheral oedema (PEROD) are presented. They were followed for many years, had multiple hospital admissions and clinic evaluations, had repeated laboratory testing, and many ECGs recorded. As their condition worsened, they developed attenuation of the ECG voltage (ATTECGV), which was more pronounced during intervals of increased fluid overload. Attenuation of the ECG voltage was decreased at times of successful diuresis and amelioration of PEROD, while abdominal paracenteses for ASC did not have any influence on the ATTECGV, suggesting that ATTECGV in patients with CIR is due to the associated PEROD, and not to ASC.

Key Words: Cirrhosis, Ascites, Peripheral oedema, Electrocardiography, Electrophysiology, Attenuation of the ECG voltage, Body volume conductor, Electrical impedance

* Corresponding author. Tel: +718 334 5005; fax: +718 334 5990. E-mail address: madiasj{at}nychhc.org

Manuscript submitted 17 July 2006. Accepted after revision 17 November 2006.


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