Coronary anatomy characteristics in patients with isolated right bundle branch block versus subjects with normal
Marziyeh Pakbaz1, Ali Kazemisaeid, Ahmad Yaminisharif
1Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Individuals with isolated right bundle branch block (RBBB) show distinct coronary artery variations compared to healthy individuals. This study highlights differences in septal and conus branches, and atrioventricular node artery origin.
Area of Science:
- Cardiology
- Anatomy
- Medical Imaging
Background:
- Isolated right bundle branch block (RBBB) is a prevalent electrocardiographic finding.
- Potential associations between RBBB and coronary anatomy variations warrant investigation.
Purpose of the Study:
- To investigate and compare coronary artery anatomy in patients with isolated RBBB versus individuals with normal electrocardiograms.
- To identify specific anatomical differences that may be associated with RBBB.
Main Methods:
- A case-control study design was employed.
- Coronary anatomy was analyzed from angiographic films.
- Two groups were compared: 92 patients with RBBB and 184 controls with normal ECGs.
Main Results:
- No significant differences were observed in left anterior descending artery size, arterial dominance, or the number/position of obtuse marginal, diagonal, and acute marginal arteries.
- Patients with RBBB exhibited a higher number of septal branches (p<0.001).
- A greater tendency for the atrioventricular node artery to originate from the right system (p=0.021) and a higher frequency of a normal conus branch (p=0.009) were noted in the RBBB group.
Conclusions:
- Coronary anatomy characteristics differ between individuals with RBBB and those with normal coronary arteries.
- Specific variations in septal branches, AV node artery origin, and conus branch anatomy are associated with RBBB.
Introduction And Objective:
Isolated right bundle branch block is a common finding in the general population. It may be associated with variations in detailed coronary anatomy characteristics. The aim of this study was to investigate the coronary anatomy in patients with isolated right bundle branch block and to compare that with normal individuals.
Method:
In this case-control study we investigated the coronary anatomy by reviewing angiographic films in two groups of normal coronary artery patients: patients with right bundle branch block (RBBB) (n = 92) and those with normal electrocardiograms (n = 184).
Results:
There was no significant difference between the two groups in terms of diminutive left anterior descending artery, dominancy, number of obtuse marginal artery, diagonal, acute marginal artery, the position of the first septal versus diagonal branch, presence of ramus artery, and size of left main artery. The number of septal branches was higher in the case group (p-value <0.001). Origination of the atrioventricular node artery from the right circulatory system was more common in both groups but cases showed more tendency to follow this pattern (p-value = 0.021). The frequency of the normal conus branch was higher in the cases versus controls (p-value = 0.009).
Conclusions:
Coronary anatomy characteristics are somewhat different in subjects with RBBB compared to normal individuals.
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