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Crochet Leads the Way

Jan Zeman1, Avtandil Kochiashvili1, Rohan Naik2

  • 1Department of Internal Medicine, University of Connecticut, Farmington, Connecticut USA.

JACC. Case Reports
|April 20, 2023
PubMed

Insights

The crochetage sign on an electrocardiogram, along with specific heart rhythm abnormalities, strongly indicates an atrial septal defect. These ECG findings are key indicators for diagnosing this heart condition.

Area of Science:

  • Cardiology
  • Diagnostic Electrocardiography

Background:

  • Atrial septal defects (ASDs) are congenital heart conditions that can lead to significant cardiovascular complications.
  • Early and accurate diagnosis of ASDs is crucial for timely intervention and management.

Purpose of the Study:

  • To identify specific electrocardiogram (ECG) findings suggestive of atrial septal defects.
  • To correlate ECG patterns with the presence of ASDs.

Main Methods:

  • Analysis of 12-lead electrocardiograms (ECGs) from patients with confirmed atrial septal defects.
  • Evaluation for the presence of the crochetage sign, right axis deviation, right bundle branch block, and right ventricular hypertrophy.

Main Results:

  • The crochetage sign, characterized by a notch near the R-wave peak in inferior leads, was observed.
  • A combination of right axis deviation, right bundle branch block (complete or incomplete), and right ventricular hypertrophy (R/S ratio >1 in lead V1) was frequently associated with ASDs.

Conclusions:

  • The presence of the crochetage sign, alongside other specific ECG criteria, is highly suggestive of atrial septal defect.
  • These ECG findings can serve as valuable non-invasive markers for diagnosing ASDs.

Keywords:
atrial septal defectelectrocardiogramimaging

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