A novel ECG based tool for diagnosing pericardial effusion: A case-control study.

Area of Science:

• Cardiology
• Medical Diagnostics
• Electrocardiography

Background:

• Traditional electrocardiogram (ECG) criteria for pericardial effusion diagnosis exhibit limited sensitivity.
• There is a need for improved non-invasive methods to detect pericardial effusion.

Purpose of the Study:

• To evaluate traditional ECG criteria in a contemporary patient group.
• To compare the diagnostic accuracy of the novel ARENA score against conventional low-voltage criteria for pericardial effusion detection.

Main Methods:

• A retrospective case-control study included 244 patients undergoing echocardiography and ECG.
• Patients were divided into derivation and validation cohorts with and without pericardial effusion.
• ECGs were analyzed using traditional low-voltage criteria and the ARENA score.

Main Results:

• In the validation cohort, the ARENA score showed significantly higher sensitivity (51.9%) compared to traditional criteria (5.6%).
• The ARENA score achieved higher accuracy (70.8%) than traditional criteria (59.7%).
• Specificity was slightly reduced with the ARENA score (82.2%) versus traditional criteria (92.2%).

Conclusions:

• The ARENA score demonstrates superior sensitivity and accuracy for detecting pericardial effusion compared to traditional low-voltage ECG criteria.
• While specificity is modestly reduced, the ARENA score represents a promising advancement in ECG-based diagnosis of pericardial effusion.