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.

P1242ECG predictors of outcome in non-left bundle branch block cardiac resynchronization therapy patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A M W Van Stipdonk ◽  
M Dural ◽  
F Salden ◽  
I A H Ter Horst ◽  
H J G M Crijns ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Patient Selection ◽  
Primary Endpoint ◽  
Left Bundle Branch Block ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Bundle Branch Block ◽  
Qrs Morphology ◽  
Qrs Duration

Abstract Background The effectiveness of cardiac resynchronization therapy (CRT) in patients without left bundle branch block (non-LBBB) QRS morphology is limited, compared to those with LBBB. Still, a substantial part of these patients can benefit from therapy and additional selection criteria are needed to identify these patients. Purpose To evaluate the association of additional baseline 12-lead ECG features; with clinical and echocardiographic outcomes in CRT-treated non-LBBB patients. Methods Pre-implantation 12-lead ECGs from 790 consecutive non-LBBB CRT patients from 3 implanting centres in the Netherlands were evaluated for the presence of predefined ECG parameters. QRS morphology (right bundle branch block and intraventricular conduction delay), QRS duration (≥/<150ms), QRS area (≥/<109μVs), left ventricular activation time ((≥/<125ms), and the presence of fragmented QRS (fQRS). The association with the primary endpoint, the combination of left ventricular assist device implantation, cardiac transplantation and all-cause mortality, was evaluated. Results There was a significantly lower occurrence of the primary endpoint in non-LBBB patients with QRS area ≥109 μVs (p<0.001) and in those without fQRS present (p=0.004) (figure 1). Figure 1 Conclusion A large QRS area and the absence of fQRS are positively associated to event free survival in non-LBBB patients treated with CRT. Whereas currently used patient selection cut-off QRS duration is not associated to outcome in these patients. These data may provide additional value for the non-LBBB patient selection for CRT and warrant prospective evaluation of these ECG features. Acknowledgement/Funding None

scholarly journals Intraventricular Conduction Delay in a Standard 12-Lead Electrocardiogram as a Predictor of Mortality in the General Population

2011 ◽  
Vol 4 (5) ◽  
pp. 704-710 ◽  
Author(s):  
Aapo L. Aro ◽  
Olli Anttonen ◽  
Jani T. Tikkanen ◽  
M. Juhani Junttila ◽  
Tuomas Kerola ◽  
...  
Keyword(s):  
General Population ◽  
Conduction Delay ◽  
Intraventricular Conduction ◽  
Intraventricular Conduction Delay

scholarly journals Predicting sudden cardiac death in a general population using an electrocardiographic risk score

Heart ◽  
2019 ◽  
Vol 106 (6) ◽  
pp. 427-433 ◽  
Author(s):  
Arttu Holkeri ◽  
Antti Eranti ◽  
M Anette E Haukilahti ◽  
Tuomas Kerola ◽  
Tuomas V Kenttä ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
General Population ◽  
Risk Score ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Wave Inversion ◽  
Population Cohort ◽  
General Population Cohort ◽  
Qrs Duration ◽  
Ecg Abnormalities

ObjectiveWe investigated whether combining several ECG abnormalities would identify general population subjects with a high sudden cardiac death (SCD) risk.MethodsIn a sample of 6830 participants (mean age 51.2±13.9 years; 45.5% male) in the Mini-Finland Health Survey, a general population cohort representative of the Finnish adults aged ≥30 years conducted in 1978–1980, we examined their ECGs, following subjects for 24.3±10.4 years. We analysed the association between individual ECG abnormalities and 10-year SCD risk and developed a risk score using five ECG abnormalities independently associated with SCD risk: heart rate >80 beats per minute, PR duration >220 ms, QRS duration >110 ms, left ventricular hypertrophy and T-wave inversion. We validated the score using an external general population cohort of 10 617 subjects (mean age 44.0±8.5 years; 52.7% male).ResultsNo ECG abnormalities were present in 4563 subjects (66.8%), while 96 subjects (1.4%) had ≥3 ECG abnormalities. After adjusting for clinical factors, the SCD risk increased progressively with each additional ECG abnormality. Subjects with ≥3 ECG abnormalities had an HR of 10.23 (95% CI 5.29 to 19.80) for SCD compared with those without abnormalities. The risk score similarly predicted SCD risk in the validation cohort, in which subjects with ≥3 ECG abnormalities had HR 10.82 (95% CI 3.23 to 36.25) for SCD compared with those without abnormalities.ConclusionThe ECG risk score successfully identified general population subjects with a high SCD risk. Combining ECG risk markers may improve the risk stratification for SCD.

Sign in / Sign up

Export Citation Format

Share Document