title: The value of electrocardiographic abnormalities in the prognosis of pulmonary embolism: a consensus paper.
abstract: Electrocardiographic (ECG) abnormalities in the setting of acute pulmonary embolism (PE) are being increasingly characterized and mounting evidence suggests that ECG plays a valuable role in prognostication for PE. We review the historical 21-point ECG prognostic score for the severity of PE and examine the updated evidence surrounding the utility of ECG abnormalities in prognostication for severity of acute PE. We performed a literature search of MEDLINE, EMBASE, and PubMed up to February 2015. Article titles and abstracts were screened, and articles were included if they were observational studies that used a surface 12-lead ECG as the instrument for measurement, a diagnosis of PE was confirmed by imaging, arteriography or autopsy, and analysis of prognostic outcomes was performed. Thirty-six articles met our inclusion criteria. We review the prognostic value of ECG abnormalities included in the 21-point ECG score, including new evidence that has arisen since the time of its publication. We also discuss the potential prognostic value of several ECG abnormalities with newly identified prognostic value in the setting of acute PE.
authors.affiliation: Department of Medicine, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
authors.forename: Geneviève C
authors.initials: GC
authors.lastname: Digby
authors.affiliation: Department of Cardiology and Internal  Medicine, Specialistic Hospital, Gorlice, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kukla
authors.affiliation: Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan City, China.
authors.forename: Zhong-Qun
authors.initials: ZQ
authors.lastname: Zhan
authors.affiliation: Clinical Unit of Electrocardiography, Heart Institute (InCor), Clinic Hospital, Faculty of Medicine, Sao Paulo University, Sao Paulo, Brazil.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Pastore
authors.affiliation: Telecardiology Center, Institute of Cardiology, Warsaw, Poland.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Piotrowicz
authors.affiliation: Iberoamerican Forum of Arrhythmias in the Internet, (FIAI), Buenos Aires, Argentina.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Schapachnik
authors.affiliation: The Heart Research Follow-up Program, Cardiology Unit, University of Rochester Medical Center, Rochester, NY.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zareba
authors.affiliation: ICCC-Hospital Sant Pau, Barcelona, Catalunya, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bayés de Luna
authors.affiliation: Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warszawa, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Pruszczyk
authors.affiliation: Department of Medicine, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
authors.forename: Adrian M
authors.initials: AM
authors.lastname: Baranchuk
mesh_terms: D000208:Acute Disease; D004562:Electrocardiography; D006801:Humans; D011379:Prognosis; D011655:Pulmonary Embolism / Q000175:diagnosis*; D012720:Severity of Illness Index
keywords: ECG; pulmonary embolism; risk score