title: Defective T wave combined with incomplete right bundle branch block: a new electrocardiographic index for diagnosing atrial septal defect.
abstract: BACKGROUND
  Incomplete right bundle branch block (ICRBBB) is commonly associated with atrial septal defect (ASD), but lacks sufficient diagnostic test characteristics. An abnormal T wave is also often observed in ASD, with horizontal or inverted displacement of the proximal T wave limb in the right precordial leads, termed "defective T wave" (DTW).
  
  
  METHODS
  We examined the diagnostic test characteristics of combining ICRBBB with DTW as a new index to diagnose ASD. A total of 132 consecutive patients with ASD and 132 cases of age/gender-matched controls without ASD were enrolled.
  
  
  RESULTS
  Sensitivities of DTW, ICRBBB, and both were 87.1% - 87.9%. Specificities were 97.0%, 96.2%, and 100%, respectively. Positive predictive values were 1.3%, 1.1%, and 100.0% respectively, while negative predictive values were 99.9% for each.
  
  
  CONCLUSIONS
  Combining ICRBBB with DTW in electrocardiogram (ECG) as a new index significantly increased the specificity and positive predictive values while maintaining a high sensitivity in diagnosing ASD.
authors.affiliation: Department of Cardiovascular Disease, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
authors.forename: Mu-xuan
authors.initials: MX
authors.lastname: Wang
authors.forename: Gui-fu
authors.initials: GF
authors.lastname: Wu
authors.forename: Jing-li
authors.initials: JL
authors.lastname: Gu
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Kun
authors.initials: K
authors.lastname: Lu
authors.forename: Da
authors.initials: D
authors.lastname: Yang
authors.forename: Long
authors.initials: L
authors.lastname: Chen
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
authors.forename: Fu-tian
authors.initials: FT
authors.lastname: Luo
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Michaels
authors.forename: Hong
authors.initials: H
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity