open access

Vol 74, No 1 (2016)
Original articles
Published online: 2015-06-18
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Electrocardiographic markers of left ventricular systolic dysfunction in patients with left bundle branch block

Ali Deniz, Çağlar Özmen, Halil Aktaş, İlayda Gül Berk, Onur Sinan Deveci, Çağlar Emre Çağlıyan, Rabia Eker Akıllı, Mehmet Kanadaşı, Mesut Demir, Ayhan Usal
DOI: 10.5603/KP.a2015.0119
·
Kardiol Pol 2016;74(1):25-31.

open access

Vol 74, No 1 (2016)
Original articles
Published online: 2015-06-18

Abstract

Background: Although some patients with left bundle branch block (LBBB) have structural heart diseases, some patients with LBBB have “normal hearts”. The electrocardiography (ECG) criteria of LBBB in reduced left ventricular ejection fraction (LVEF) have not been defined completely.

Aim: The main purpose of this study was to differentiate patients with reduced LVEF from patients with normal left ventricular systolic function simply by analysing 12-lead ECG.

Methods: Subjects admitted to our hospital with LBBB in their ECG were included in the study. The patients were categorised according to their left ventricular systolic function as group 1 (LVEF ≥ 50%) and group 2 (LVEF < 50%). Duration of the QRS complex, residual conduction of left bundle branch, and concordance/discordance of T waves in leads V5, V6, or D1 were recorded. The ECG findings of the two groups were compared.

Results: One hundred consecutive patients with LBBB were included in the study (male/female: 56/44, age: 66 ± 15 years). In the whole group, there were 35 patients with normal left ventricular systolic function (LVEF ≥ 50%), and 65 patients had LVEF below 50%. 80% of male patients with LBBB and 45% of female patients with LBBB had their LVEF below 50% (p < 0.001). Mean QRS durations of group 1 and group 2 were 132 ± 10 ms vs. 152 ± 22 ms, respectively (p < 0.001). The QRS duration of 140 ms was found to be the cut-off value to differentiate group 1 from group 2, with sensitivity and specificity of 72% and 75%, respectively. Twenty-one per cent of patients in group 1 and 69% in group 2 had discordant LBBB (p < 0.001). Residual conduction of left bundle branch was more frequent in group 2 (29% in group 1 vs. 52% in group 2, p = 0.03).

Conclusions: Male gender, QRS duration greater than 140 ms, discordant LBBB, and residual conduction in the left bundle branch seem to be markers of reduced LVEF in patients with LBBB.

Abstract

Background: Although some patients with left bundle branch block (LBBB) have structural heart diseases, some patients with LBBB have “normal hearts”. The electrocardiography (ECG) criteria of LBBB in reduced left ventricular ejection fraction (LVEF) have not been defined completely.

Aim: The main purpose of this study was to differentiate patients with reduced LVEF from patients with normal left ventricular systolic function simply by analysing 12-lead ECG.

Methods: Subjects admitted to our hospital with LBBB in their ECG were included in the study. The patients were categorised according to their left ventricular systolic function as group 1 (LVEF ≥ 50%) and group 2 (LVEF < 50%). Duration of the QRS complex, residual conduction of left bundle branch, and concordance/discordance of T waves in leads V5, V6, or D1 were recorded. The ECG findings of the two groups were compared.

Results: One hundred consecutive patients with LBBB were included in the study (male/female: 56/44, age: 66 ± 15 years). In the whole group, there were 35 patients with normal left ventricular systolic function (LVEF ≥ 50%), and 65 patients had LVEF below 50%. 80% of male patients with LBBB and 45% of female patients with LBBB had their LVEF below 50% (p < 0.001). Mean QRS durations of group 1 and group 2 were 132 ± 10 ms vs. 152 ± 22 ms, respectively (p < 0.001). The QRS duration of 140 ms was found to be the cut-off value to differentiate group 1 from group 2, with sensitivity and specificity of 72% and 75%, respectively. Twenty-one per cent of patients in group 1 and 69% in group 2 had discordant LBBB (p < 0.001). Residual conduction of left bundle branch was more frequent in group 2 (29% in group 1 vs. 52% in group 2, p = 0.03).

Conclusions: Male gender, QRS duration greater than 140 ms, discordant LBBB, and residual conduction in the left bundle branch seem to be markers of reduced LVEF in patients with LBBB.

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Keywords

heart failure, systolic dysfunction, left bundle branch block

About this article
Title

Electrocardiographic markers of left ventricular systolic dysfunction in patients with left bundle branch block

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 74, No 1 (2016)

Pages

25-31

Published online

2015-06-18

DOI

10.5603/KP.a2015.0119

Bibliographic record

Kardiol Pol 2016;74(1):25-31.

Keywords

heart failure
systolic dysfunction
left bundle branch block

Authors

Ali Deniz
Çağlar Özmen
Halil Aktaş
İlayda Gül Berk
Onur Sinan Deveci
Çağlar Emre Çağlıyan
Rabia Eker Akıllı
Mehmet Kanadaşı
Mesut Demir
Ayhan Usal

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