Prevalence and frequency of arrhythmias and electrocardiographic abnormalities in Pakistan: An outpatient ECG-based study

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Rhythm O2 Pub Date : 2025-04-01 DOI:10.1016/j.hroo.2024.12.017

Aiysha Nasir MBBS, FCPS, Armughan Tauheed Farooqi MBBS, Saadia Sattar MSc, Yawer Saeed MRCP, PhD

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Abstract

Background

Little is known about the prevalence of arrhythmias in Pakistan. We assessed the frequency of arrhythmias and electrocardiographic (ECG) abnormalities among the Pakistani population, attending the outpatient department, categorized by age, gender, and geographic region.

Objective

This study aimed to evaluate variations in arrhythmia prevalence and ECG abnormalities across a large sample of a South Asian population.

Methods

This retrospective study analyzed 8746 ECGs from Aga Khan University Hospital in 2022. The ECGs were digitally saved, initially interpreted by an ECG-trained cardiac technician, reviewed by a junior cardiologist using the Minnesota Code, and validated by a senior cardiologist. An electrophysiologist resolved discrepancies to ensure accurate final results.

Results

A total of 8746 ECGs were analyzed (56.86% from men). The prevalences of common arrhythmia were sinus bradycardia 8.53%, sinus tachycardia 5.08%, atrial fibrillation (AF) (1.17%), atrial flutter (AFL) (0.18%), first-degree atrioventricular (AV) block (1.31%), and other AV blocks (0.14%). Women had more sinus tachycardia (6.44%, P <.05), AF (1.59%, P <.001), and poor R-wave progression (6.41%, P <.005), whereas men had more sinus bradycardia (10.68%, P <.05), left-anteiror fasicular block (8.32%, P <.005), left ventricular hypertrophy (LVH) (2.59%, P <.005), pathologic Q waves (3.86%, P <.005), and early repolarization pattern (5.87%, P <.05). Patients from Khyber Pakhtunkhwa region had higher rates of LVH (7.69%, P <.005) and AF (3.85%, P <.05). In contrast, patients from Gilgit-Baltistan had the highest rates of sinus bradycardia (28.57%, P <.005). Right bundle branch block (10.61%, P <.005) and long QT (3.79%, P <.005) were more prevalent in the youngest population, whereas patients aged >65 years had more AF (3.31%, P <.005), AFL (0.59%, P <.005), sinus bradycardia (10.71%, P <.001), first-degree AV block (4.62%, P <.005), left anterior fascicular block (13.08%, P <.005), left bundle branch block (2.43%, P <.005), poor R-wave progression (8.82%, P <.005), and pathologic Q waves (5.98%, P <.005).

Conclusion

This study details important information about arrhythmia prevalence in a large sample of a South Asian population. AF is more common in women, the elderly, and people from Khyber Pakhtunkhwa.

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巴基斯坦心律失常和心电图异常的患病率和频率：一项基于心电图的门诊研究

背景：在巴基斯坦，人们对心律失常的患病率知之甚少。我们评估了就诊于门诊的巴基斯坦人群中心律失常和心电图（ECG）异常的频率，并按年龄、性别和地理区域进行分类。目的本研究旨在评估南亚人群大样本中心律失常患病率和心电图异常的变化。方法回顾性分析2022年阿迦汗大学医院8746例心电图。心电图被数字化保存，最初由心电图训练有素的心脏技术人员解释，由初级心脏病专家使用明尼苏达州代码进行检查，并由高级心脏病专家进行验证。电生理学家解决差异，以确保准确的最终结果。结果共分析心电图8746张（男性56.86%）。常见心律失常发生率为窦性心动过缓8.53%、窦性心动过速5.08%、心房颤动（AF） 1.17%、心房扑动（AFL） 0.18%、一级房室传导阻滞（1.31%）、其他房室传导阻滞（0.14%）。女性有较多的窦性心动过速（6.44%,P < 0.05）、房颤（1.59%,P < 0.001）和r波进展差（6.41%,P < 0.05），而男性有较多的窦性心动过缓（10.68%,P < 0.05）、左前束阻滞（8.32%,P < 0.05）、左室肥厚（2.59%,P < 0.05）、病理性Q波（3.86%,P < 0.05）和早期复极模式（5.87%,P < 0.05）。开伯尔-普赫图赫瓦地区患者LVH发生率（7.69%,P < 0.05）和AF发生率（3.85%,P < 0.05）较高。相比之下，吉尔吉特-巴尔蒂斯坦的患者窦性心动过缓的发生率最高（28.57%,P < 005）。右束支传导阻滞（10.61%,P < 0.005）和长QT间期（3.79%,P < 0.005）在年轻人群中更为普遍，而65岁患者的房颤（3.31%,P < 0.005）、AFL （0.59%, P < 0.005）、窦性心动过缓（10.71%,P < 0.005）、一级房室传导阻滞（4.62%,P < 0.005）、左束前束传导阻滞（13.08%,P < 0.005）、左束支传导阻滞（2.43%,P < 0.005）、r波进展不良（8.82%,P < 0.005）和病理性Q波（5.98%,P < 0.005）较多。结论：本研究详细介绍了南亚大样本人群中心律失常患病率的重要信息。房颤在妇女、老年人和开伯尔-普赫图赫瓦省的人群中更为常见。

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