Electrocardiographic characteristics in the patients with a persistent left superior vena cava
A persistent left superior vena cava (PLSVC) is a congenital venous abnormality and is usually asymptomatic and does not cause hemodynamic disturbances. Therefore, it is difficult to identify it by routine examinations in clinical practice. This study aimed to elucidate the electrocardiographic characteristics for the prediction of a PLSVC. Twelve patients (9 males, 56.2 ± 18.3 years) who were diagnosed with a PLSVC were enrolled. The electrocardiographic parameters, including the P-wave duration, axis, and morphology of the P waves, were automatically measured and compared to 150 controls (77 males, 57.3 ± 14.6 years). There were no significant differences in the P-wave duration. Negative or positive/negative P waves in lead III predicted a PLSVC with a sensitivity of 100% and specificity of 81%. The P-wave axis in PLSVC exhibited a significant leftward deviation as compared to the controls (14.8 ± 21.1 vs. 54.0 ± 17.4°, p < 0.001). A receiver operating characteristic curve analysis of the P-wave axis for predicting a PLSVC exhibited an area under curve of 0.93 [CI 95% (0.87–0.98), p < 0.001), and identified a P-wave axis of less than 37.5° to have a 92% sensitivity and 83% specificity in predicting a PLSVC. A negative or positive/negative P-wave morphology in lead III was a useful finding for suggesting the presence of a PLSVC.
KeywordsPersistent left superior vena cava P-wave morphology P-wave axis Electrocardiogram
Superior vena cava
Persistent left superior vena cava
We thank Mr. John Martin for his linguistic assistance.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 6.Hassine M, Hamdi S, Chniti G, Boussaada M, Bouchehda N, Mahjoub M, Ben Hamda K, Betbout F, Maatouk F, Gamra H (2015) Permanent cardiac pacing in a patient with persistent left superior vena cava and concomitant agenesis of the right-sided superior vena cava. J Arrhythmia 31:326–327CrossRefGoogle Scholar
- 15.Kolski BC, Khadivi B, Anawati M, Daniels LB, Demaria AN, Blanchard DG (2011) The dilated coronary sinus: utility of coronary sinus cross-sectional area and eccentricity index in differentiating right atrial pressure overload from persistent left superior vena cava. Echocardiography 28:829–832CrossRefGoogle Scholar
- 31.Bayes de Luna A, Platonov P, Cosio FG, Cygankiewicz I, Pastore C, Baranowski R, Bayes-Genis A, Guindo J, Vinolas X, Garcia-Niebla J, Barbosa R, Stern S, Spodick D (2012) Interatrial blocks. A separate entity from left atrial enlargement: a consensus report. J Electrocardiol 45:445–451CrossRefGoogle Scholar