Electrocardiogram Findings in Cardiac Cystic Echinococcosis: A Systematic Review and Meta-Analysis

Authors
Rasa Beheshti
Erfan Banisefid
Kosar Baghernezhad
Amirreza Naseri
Hamid Owaysee Osquee
Elnaz Javanshir
10.61186/ibj.25th-11th-IACRTIMSS
Abstract
Introduction: Human cystic echinococcosis (CE), a hydatid disease, is a tissue infestation endemic in numerous sheep-farming areas, notably Mediterranean countries, the Middle East, South America, and Australia. Cardiac CE is an infrequent expression of Echinococcus infection, representing 0.5% to 2% of the CE cases. This systematic review and meta-analysis aimed to review cardiac CE in electrocardiogram (ECG) findings comprehensively.

Search Study: We have included all of the case series studies that presented the ECG findings of cardiac CE. Non-English studies, conference abstracts, review studies, letters, and commentaries were excluded. A systematic search was conducted in PubMed and Embase from inception to March 2022. JBI critical appraisal tool for case series was utilized for quality assessments. Meta-analysis of the proportion of normal sinus rythme (NSR) among Cardiac CE patients was performed using the CMA3. High heterogeneity was identified by the I2 statistics of more than 50%, and I2 statistics below 50% were identified as low heterogeneity. A fixed effect was used in cases of low heterogeneity; otherwise, a random effect was used.

Results: Among 3,985 records, 20 studies reported the ECG findings. Based on the quantitative synthesis, the proportion of patients with NSR was 48.3% (9 studies; 95% CI: 38.8%-57.9%; I2: 43.99%; p value for heterogeneity = 0.075).

Conclusion and Discussion: Non-specific signs and ECG changes make cardiac CE a diagnostic challenge. NSR is the most commonly presented ECG finding in cardiac CE, highlighting the method's lack of diagnostic accuracy.



Keywords
Echinococcosis
meta-analysis
Systematic review