The role of oesophageal electrocardiography in the diagnosis of right ventricular hypertrophy in chronic obstructive pulmonary disease

Oesophageal electrocardiograms were recorded in 25 normal persons, 20 patients with chronic bronchitis and predominant emphysema without right ventricular hypertropy and 25 patients with chronic cor pulmonale as an end result of chronic obstructive pulmonary disease. At ventricular level, patients with chronic cor pulmonale had higher P wave height, lower Q wave depth, lower R wave height, deeper S waves and lower R S ratio as compared to the group with emphysema. In terms of the transitional zone, patients with cor pulmonale had smaller Q waves and a lower R R ratio. At atrial level, the patients with cor pulmonale had higher heights of the P and R waves and a lower Q R ratio. All these differences were highly significant statistically (P < 0.001). An R S ratio of less than 2.5 at ventricular level had high sensitivity (96.0%), specificity (100%) and accurace (98%) in diagnosing right ventricular hypertrophy in cases of chronic obstructive pulmonary disease. This criterion obtained from the oesophageal electrocardiogram is much more sensitive and accurate than those obtained routinely from the surface electrocardiogram in diagnosing right ventricular hypertrophy in cases of chronic obstructive pulmonary disease.