Study objective and method

Determine independent ECG predictors of AFD

Validate an ECG scoring system for differential diagnosis of AFD

Results

Anderson–Fabry ECG score

Score calculation	PR interval	<120 ms	1
		120- 199 ms	0
		≥200 ms	2
	QRS duration	<100 ms	0
		100–119 ms	1
		120–139 ms	2
		≥140 ms	3
	RBBB (complete and incomplete)	Yes	2
	RBBB (complete and incomplete)	No	0
	R in aVL ≥11 mV	Yes	1
	R in aVL ≥11 mV	No	0
	Inferior ST-segment depression	Yes	3
	Inferior ST-segment depression	No	0

Algorithm for step-by–step analysis of the ECG for AFD

Conclusion

Independent predictors of AFD diagnosis

Short PR interval

Prolonged QRS duration

RBBB

R in aVL ≥1.1 mV

Inferior ST-segment depression

A stepwise ECG scoring system

Good

diagnostic performance

Discriminates unexplained LVH

Providing clinical and therapeutic implications

AFD: Anderson–Fabry disease; aVF: Augmented vector foot; aVL: Augmented vector left; ECG: Electrocardiogram; HCM: Hypertrophic cardiomyopathy; LVH: Left ventricular hypertrophy; MS: Millisecond; mV: Millivolt; RBBB: Right bundle branch block.

Reference

Vitale G, Ditaranto R, Graziani F, et al. Standard ECG for differential diagnosis between Anderson-Fabry disease and hypertrophic cardiomyopathy. Heart. 2022;108(1):54–60.