scholarly journals THE UNFAVORABLE RELATION OF VENTRICULAR CONDUCTION DELAY, DYSFUNCTION AND REMODELING IN ISOLATED LEFT BUNDLE-BRANCH BLOCK

2020 ◽  
Vol 75 (11) ◽  
pp. 1671
Author(s):  
Janek Salatzki ◽  
Theresa Fischer ◽  
Johannes Riffel ◽  
Florian André ◽  
Kristóf Hirschberg ◽  
...  
Keyword(s):  
Left Bundle Branch Block ◽  
Conduction Delay ◽  
Bundle Branch Block ◽  
Ventricular Conduction

Transient Left Bundle Branch Block in a Neonate

PEDIATRICS ◽  
1969 ◽  
Vol 44 (4) ◽  
pp. 609-613
Author(s):  
Dorothy Brinsfield
Keyword(s):  
Congenital Anomaly ◽  
Left Bundle Branch Block ◽  
Clinical Evidence ◽  
Similar Case ◽  
Heart Sound ◽  
Left Ventricular ◽  
Conduction Delay ◽  
Bundle Branch Block ◽  
Second Heart Sound ◽  
Ventricular Conduction

A neonate with transient, benign left bundle branch block has been presented. There is no similar case report in the literature. The etiology of the left ventricular conduction delay is unknown, but there was no clinical evidence of a congenital anomaly or of infectious mayocarditis. The finidings of this infant differed from those of adults in that there was wide splitting of the second heart sound throughout the respiratory cycle, no gallop sounds, and the initial forces of the QRS were atypical. These differences are thought to represent the expected findings of LBBB in a newborn.

Abstract 13286: Non-Specific Intraventricular Conduction Delay and Risk of Sudden Death

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Audrey Uy-Evanado ◽  
Carmen Teodorescu ◽  
Kyndaron Reinier ◽  
Kumar Narayanan ◽  
Harpriya Chugh ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
General Population ◽  
Left Bundle Branch Block ◽  
Cardiac Death ◽  
Conduction Delay ◽  
Bundle Branch Block ◽  
Intraventricular Conduction ◽  
Qrs Morphology ◽  
Qrs Duration ◽  
Intraventricular Conduction Delay

Introduction: We and others have reported an independent association between prolonged QRS duration and risk of sudden cardiac death (SCD) in the general population. Left and right bundle branch block have been studied previously, but there is little information regarding non-specific intraventricular conduction delay and risk of SCD. Hypothesis: Completed conduction defects, including non-specific IVCD, are associated with increased SCD risk. Methods: Sudden cardiac death cases and controls from an ongoing large population based study in the Northwestern US (2002 to 2010) were included if age ≥ 35 years with a non-paced 12-lead ECG (recorded prior and unrelated to SCD in cases). QRS morphology was subcategorized as normal, intermediate [left anterior fascicular block (LAFB), left posterior fascicular block (LPFB), and incomplete right or left bundle branch block (IRBBB/ILBBB)] or completed conduction defects [left bundle branch block (LBBB), right bundle branch block (RBBB), or nonspecific intraventricular conduction delay (IVCD)]. Comparisons were conducted using chi-square tests for categorical variables and independent samples t-tests for continuous variables. Logistic regression was used to evaluate the association of QRS morphology with SCD. Results: We evaluated 761 SCD cases (64% male) and 539 controls (65% male). Cases were significantly older (69.7 vs 66.3 years, p<0.0001) with greater QRS duration (102 vs. 98 ms, p=0.001). For conduction categories, intermediate or completed conduction defects were significantly more common in cases whereas normal QRS morphology was more common among controls (p=0.01). And for specific morphology overall, QRS morphology patterns differed between cases and controls (p=0.03); abnormal QRS morphologies were more frequent in cases than controls except for LAFB. After adjustment for age and gender, however, only a finding of LBBB or non-specific IVCD remained a significant predictor of SCD [OR 1.34 (95% CI 1.03-1.75)]. Conclusions: LBBB and non-specific IVCD, but not RBBB, are significant predictors of SCD in the general population. These findings contribute to the utility of the 12-lead EKG for SCD risk stratification.

Non-invasive predictors for infranodal conduction delay in patients with left bundle branch block after TAVR

2021 ◽  
Author(s):  
Chloé Auberson ◽  
Patrick Badertscher ◽  
Antonio Madaffari ◽  
Meriton Malushi ◽  
Luc Bourquin ◽  
...  
Keyword(s):  
Left Bundle Branch Block ◽  
Predictive Value ◽  
Conduction Delay ◽  
Bundle Branch Block ◽  
Non Invasive ◽  
Transcatheter Aortic Valve ◽  
Increased Risk ◽  
Surface Ecg ◽  
Pr Interval ◽  
Electrocardiographic Parameters

Abstract Aims Left bundle branch block (LBBB) is the most common conduction disorder after transcatheter aortic valve replacement (TAVR) with an increased risk of atrioventricular (AV) block. The aim of the current study was to identify non-invasive predictors for infranodal conduction delay in patients with LBBB. Methods We analyzed consecutive patients undergoing TAVR with pre-existing or new-onset LBBB between August 2014 and August 2020. His ventricular (HV) interval measurement was performed on day 1 after TAVR. Baseline, procedural, as well as surface and intracardiac electrocardiographic parameters were included. Infranodal conduction delay was defined as HV interval > 55 ms. Results Of 825 patients screened after TAVR, 151 patients (82 ± 6 years, 39% male) with LBBB were included. Among these, infranodal conduction delay was observed in 25%. ΔPR (difference in PR interval after and before TAVR), PR and QRS duration after TAVR were significantly longer in the group with HV prolongation. In a multivariate analysis in patients with sinus rhythm (n = 123), ΔPR (OR per 10 ms increase: 1.52; 95%CI: 1.19–2.01; p = 0.002) was the only independent factor associated with infranodal conduction delay. A change in PR interval by 20 ms yielded a specificity of 83% and a sensitivity of 46%, with a negative predictive value of 84% and a positive predictive value of 45% to predict HV prolongation. Conclusions Simple analysis of surface ECG and a calculated ΔPR < 20 ms can be used as predictor for the absence of infranodal conduction delay in post-TAVR patients with LBBB. Graphical abstract

scholarly journals Non-invasive predictors for infranodal conduction delay in patients with left bundle branch block after transcatheter aortic valve replacement

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
C Auberson ◽  
P Badertscher ◽  
A Madaffari ◽  
M Malushi ◽  
L Bourquin ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Left Bundle Branch Block ◽  
Predictive Value ◽  
Transcatheter Aortic Valve Replacement ◽  
Conduction Delay ◽  
Bundle Branch Block ◽  
Non Invasive ◽  
Transcatheter Aortic Valve ◽  
Pr Interval

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Left bundle branch block (LBBB) is the most common conduction disorder after transcatheter aortic valve replacement (TAVR) with an increased risk of atrioventricular (AV) block. The aim of the current study was to identify non-invasive predictors for infranodal conduction delay in patients with LBBB. Methods We analyzed consecutive patients undergoing TAVR with pre-existing or new-onset LBBB between August 2014 and August 2020. His ventricular (HV) interval measurement was performed on day 1 after TAVR. Baseline, procedural, as well as surface and intracardiac electrocardiographic parameters were included. Infranodal conduction delay was defined as HV interval &gt;55 ms. Results Of 825 patients screened after TAVR, 151 patients (82 ± 6 years, 39% male) with LBBB were included. Among these, infranodal conduction delay was observed in 25%. ΔPR (difference in PR interval after and before TAVR), PR and QRS duration after TAVR were significantly longer in the group with HV prolongation. In a multivariate analysis in patients with sinus rhythm (n = 131), ΔPR (OR per 10 ms increase: 1.52; 95% CI: 1.19-2.01; p = 0.002) was the only independent factor associated with infranodal conduction delay. The AUC of the ROC curve was 0.724 (95% CI) for ΔPR. A change in PR interval by 20 ms yielded a sensitivity of 26% and specificity of 83% with a positive predictive value of 45% and a negative predictive value of 84% to predict HV prolongation. Conclusions Simple analysis of surface ECG and a calculated ΔPR &lt;20ms can be used as predictor for the absence of infranodal conduction delay in post-TAVR patients with LBBB. Abstract Figure HV

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