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

Kuniyasu Harimoto1, Tatsuya Kawasaki1, Sakiko Honda1

  • 1Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan.

Journal of Electrocardiology
|July 22, 2014
PubMed

Insights

Right bundle branch block (RBBB) can indicate ventricular septal fibrosis in hypertrophic cardiomyopathy (HCM) patients without ablation history. This finding aids in non-invasively identifying fibrosis in HCM patients.

Area of Science:

  • Cardiology
  • Biomedical Imaging
  • Electrophysiology

Background:

  • Right bundle branch block (RBBB) is linked to ventricular septal fibrosis in hypertrophic cardiomyopathy (HCM) patients post-alcohol septal ablation.
  • Limited data exists on RBBB and septal fibrosis in HCM patients without prior septal ablation.

Purpose of the Study:

  • To investigate the association between RBBB and ventricular septal fibrosis in HCM patients without a history of alcohol septal ablation.
  • To determine if RBBB can serve as a non-invasive marker for septal fibrosis in this population.

Main Methods:

  • Magnetic resonance late gadolinium enhancement (LGE) was utilized in 59 HCM patients.
  • LGE location and extent were analyzed concerning electrocardiographic features, specifically RBBB.
  • Correlation between LGE volume and QRS duration in RBBB was assessed.

Main Results:

  • HCM patients with RBBB exhibited significantly higher LGE volume compared to those without RBBB (7.3±7.4g/cm vs. 2.9±7.4g/cm, p=0.016).
  • A strong positive correlation was observed between LGE volume and RBBB QRS duration (correlation coefficient=0.93, p=0.023).
  • RBBB demonstrated high specificity (94%) but low sensitivity (21%) for detecting ventricular septal LGE.

Conclusions:

  • RBBB may serve as a simple, non-invasive marker for identifying ventricular septal fibrosis in HCM patients who have not undergone septal ablation.
  • Further research is warranted to validate these findings and their clinical implications.
Abstract

Keywords:
Hypertrophic cardiomyopathyMyocardial fibrosisRight bundle branch blockVentricular septum

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