title: Electrocardiogram interpretation and arrhythmia management: a primary and secondary care survey.
abstract: BACKGROUND
  There is increasing desire among service commissioners to treat arrhythmia in primary care. Accurate interpretation of the electrocardiogram (ECG) is fundamental to this. ECG interpretation has previously been shown to vary widely but there is little recent data.
  
  
  OBJECTIVE
  To examine the interpretation of ECGs in primary and secondary care.
  
  
  METHODS
  A cross-sectional survey of participants' interpretation of six ECGs and hypothetical management of patients based on those ECGs, at primary care educational events, and a cardiology department in Leeds.
  
  
  METHODS
  A total of 262 primary care clinicians and 20 cardiology clinicians were surveyed via questionnaire. Answers were compared with expert electrophysiologist opinion.
  
  
  RESULTS
  In primary care, abnormal ECGs were interpreted as normal by 23% of responders. ST elevation and prolonged QT were incorrectly interpreted as normal by 1% and 22%, respectively. In cardiology, abnormal ECGs were interpreted as normal by 3%.
  
  
  CONCLUSIONS
  ECG provision and interpretation remains inconsistent in both primary and secondary care. Primary care practitioners are less experienced and less confident with ECG interpretation than cardiologists, and require support in this area.
authors.affiliation: Leeds General Infirmary; Leeds Institute for Quality Healthcare; and Faculty of Medicine and Health, University of Leeds, Leeds.
authors.forename: Gordon
authors.initials: G
authors.lastname: Begg
authors.affiliation: Leeds General Infirmary; and Leeds Institute for Quality Healthcare, Leeds.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Willan
authors.affiliation: Leeds General Infirmary; and Leeds Institute for Quality Healthcare, Leeds.
authors.forename: Keith
authors.initials: K
authors.lastname: Tyndall
authors.affiliation: Leeds General Infirmary, Leeds.
authors.forename: Chris
authors.initials: C
authors.lastname: Pepper
authors.affiliation: Leeds General Infirmary; and Leeds Institute for Quality Healthcare, Leeds.
authors.forename: Muzahir
authors.initials: M
authors.lastname: Tayebjee
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D002309:Cardiology / Q000193:education*; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D004502:Education, Medical, Continuing / Q000592:standards*; D004562:Electrocardiography; D006801:Humans; D058007:Physicians, Primary Care / Q000193:education* / Q000592:standards; D011237:Predictive Value of Tests; D011320:Primary Health Care; D015203:Reproducibility of Results; D063127:Secondary Health Care; D006113:United Kingdom
keywords: cardiac arrhythmias; cardiology; electrocardiography; general practice; questionnaires