Right bundle branch block and ventricular septal fibrosis in patients with hypertrophic cardiomyopathy

Abstract Background Right bundle branch block (RBBB) is associated with ventricular septal fibrosis in patients with hypertrophic cardiomyopathy (HCM) after alcohol septal ablation, but little data are available in HCM patients without a history of septal ablation. Methods Magnetic resonance late ga...

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Bibliographic Details
Published in:Journal of electrocardiology 2014-09, Vol.47 (5), p.636-641
Main Authors: Harimoto, Kuniyasu, MD, Kawasaki, Tatsuya, MD, Honda, Sakiko, MD, Miki, Shigeyuki, MD, Kamitani, Tadaaki, MD
Format: Article
Language:English
Subjects:
Aged
Bundle-Branch Block - etiology
Bundle-Branch Block - physiopathology
Cardiomyopathy, Hypertrophic - complications
Cardiomyopathy, Hypertrophic - physiopathology
Cardiovascular
Contrast Media
Electrocardiography
Female
Fibrosis - complications
Fibrosis - physiopathology
Heart Septum - physiopathology
Humans
Hypertrophic cardiomyopathy
Magnetic Resonance Imaging
Male
Middle Aged
Myocardial fibrosis
Right bundle branch block
Sensitivity and Specificity
Ventricular septum
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Summary:Abstract Background Right bundle branch block (RBBB) is associated with ventricular septal fibrosis in patients with hypertrophic cardiomyopathy (HCM) after alcohol septal ablation, but little data are available in HCM patients without a history of septal ablation. Methods Magnetic resonance late gadolinium enhancement (LGE) was performed in 59 HCM patients with no history of alcohol septal ablation. The location and extent of LGE were examined in relation to electrocardiographic features including RBBB. Results LGE volume was higher in 7 HCM patients with RBBB (7.3 ± 7.4 g/cm) than in patients without RBBB (2.9 ± 7.4 g/cm, p = 0.016). LGE volume was positively correlated to QRS duration of RBBB (correlation coefficient = 0.93, p = 0.023). The diagnostic value of RBBB was highly specific for the detection of LGE in the ventricular septum, with sensitivity 21% and specificity 94%. Conclusions The presence of RBBB may be a simple marker for detecting ventricular septal fibrosis in HCM patients who had no history of alcohol septal ablation. Further studies are necessary to confirm our findings.
ISSN:0022-0736
1532-8430
DOI:10.1016/j.jelectrocard.2014.06.010