Electrocardiogram abnormalities detected during a routine medical examination of healthy members of the armed forces: An observational study

Abstract

Background and objective: Only few studies addressed ECG findings in healthy members of the Indian
armed forces or the general population of India. The study was conducted to assess the prevalence of
abnormal electrocardiogram (ECG) detected during a routine medical examination of healthy members of the
Indian armed forces. Method: The ECG of all the healthy members performed during a routine medical
examination was initially reported by physicians at various armed forces service hospitals in the Eastern
Command (EC) and later perused by the cardiologist at Command Hospital Eastern Command (CHEC).
Individuals with abnormal ECG underwent relevant cardiac evaluation at CHEC to determine the underlying
pathology. Results: A total of 1,045 members of the Indian armed forces were included in the study and were
categorised as follows: 244 in Group-1 (aged < 25years), 478 in Group-2 (aged between 25 to 40 years) and
323 in Group-3 (aged > 40years). Abnormal ECG was found in 108 (10.3%) individuals. Left axis deviation
was the most common abnormality detected in 18 (1.2%) individuals, followed by incomplete RBBB and T
wave inversion which were each found in 15 subjects (1.43% of all individuals and 13.9% of the subjects with
abnormal ECG). The prevalence of ECG abnormalities detected in our study was similar to that reported in
previous studies. Only five (0.47%) of the 108 individuals with abnormal ECG were found to have underlying

cardiovascular disease. Conclusion: Morphological ECG abnormalities were common in the subjects but did
not vary significantly from the general population, and only a minority had underlying pathology. While most
of the abnormalities may only represent normal variations and their occurrence in healthy individuals during
routine health check-ups should not be alarming. Evaluation of structural heart disease should be done for
ECG abnormalities with prognostic significance that has been well-characterised.