Low EF Prediction From EKG
LBBB or paced rhythm
Includes wide LBBB morphology or ventricular pacing
QRS ≥ 120 ms
Any nonspecific IVCD or BBB
Pathologic Q waves
Prior infarct pattern in contiguous leads
Poor R-wave progression
Anterior scar, LV remodeling, lead placement issue
LVH with strain
Lateral ST depression/TWI with LVH voltage
AF or flutter
Current rhythm on EKG
Frequent PVCs / NSVT
Ectopy, couplets, runs, or high PVC burden suspected
Low voltage
Limb leads <5 mm or precordial <10 mm
Resting HR ≥ 100
Sinus tachycardia or atrial arrhythmia
Score: 0
Low probability of low EF
No major EKG markers of cardiomyopathy. Low EF still possible if symptoms, HF history, murmur, cardiotoxic therapy, abnormal BNP, cardiomegaly, or prior MI.
References
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