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. 2023 Apr 7:13:101814.
doi: 10.1016/j.jaccas.2023.101814. eCollection 2023 May 3.

Crochet Leads the Way

Jan Zeman  1 , Avtandil Kochiashvili  1 , Rohan Naik  2 , Erind Muco  1 , Agnes S Kim  2
Affiliations

Crochet Leads the Way

Jan Zeman et al. JACC Case Rep. .

Abstract

The crochetage sign-a notch near the R-wave peak in the inferior leads-in conjunction with right axis deviation, complete or incomplete right bundle branch block, and right ventricular hypertrophy (R/S ratio >1 in lead V1) on 12-lead electrocardiogram are highly suggestive of atrial septal defect. (Level of Difficulty: Intermediate.).

Keywords: atrial septal defect; electrocardiogram; imaging.

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Conflict of interest statement

The funding for the article publishing charge has been provided by the Letts O'Brien Fund. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Initial ECG Showing Right Axis Deviation With Crochetage Pattern in Leads II, III, and aVF ECG = electrocardiogram.
Figure 2
Figure 2
ECG With Highlighted QRS Complexes Depicting the Most Prominent Crochetage Signs Red circles highlight inferior ECG leads where the crochetage sign is most common. Black arrows are pointing toward the notch. Abbreviation as in Figure 1.
See this image and copyright information in PMC

References

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    1. Toscano Barboza E., Brandenburg R.O., Swan H.J. Atrial septal defect; the electrocardiogram and its hemodynamic correlation in 100 proved cases. Am J Cardiol. 1958;2(6):698–713. - PubMed
    1. Schiller O., Greene E.A., Moak J.P., Gierdalski M., Berul C.I. The poor performance of RSR' pattern on electrocardiogram lead V1 for detection of secundum atrial septal defects in children. J Pediatr. 2013;162(2):308–312. - PubMed

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