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Right Bundle Branch Block Predicts Appropriate Implantable Cardioverter Defibrillator Therapies in Patients with

Marta Jiménez-Blanco Bravo1,2, Gonzalo Luis Alonso Salinas3,4,5, Carolina Parra Esteban6

  • 1Cardiology Department, Hospital Universitario Ramón y Cajal, Carretera de Colmenar Vieno km 9100, 28034 Madrid, Spain.

Diagnostics (Basel, Switzerland)
|June 19, 2024
PubMed

Insights

Right bundle branch blocks (RBBB) may help identify patients with non-ischemic dilated cardiomyopathy (NICM) at high risk for sudden cardiac death. This finding aids in selecting patients who may benefit from prophylactic implantable cardioverter defibrillators (ICDs).

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • The efficacy of prophylactic implantable cardioverter defibrillators (ICDs) in severe non-ischemic systolic dysfunction remains uncertain.
  • Identifying patients at high risk for sudden cardiac death (SCD) in this population is a significant clinical challenge.

Purpose of the Study:

  • To retrospectively identify predictors of appropriate ICD therapies in patients with non-ischemic dilated cardiomyopathy (NICM).
  • To evaluate the role of electrocardiographic (ECG) findings in risk stratification for ventricular arrhythmias.

Main Methods:

  • Retrospective review of 224 consecutive NICM patients who received prophylactic ICDs between 2008 and 2020.
  • Analysis of patient demographics, clinical characteristics, ECG findings, and ICD therapy data.
  • Multivariate competing-risks regression to determine independent predictors of appropriate ICD therapies.

Main Results:

  • Over a median follow-up of 51 months, 27.2% of patients received appropriate ICD therapies.
  • Patients with appropriate therapies were more often male, younger, and exhibited more right bundle branch blocks (RBBB) and less left bundle branch blocks (LBBB).
  • RBBB was identified as an independent predictor of appropriate ICD therapies (HR 2.26, p=0.043).

Conclusions:

  • Right bundle branch block (RBBB) on ECG may serve as a valuable marker for identifying NICM patients at increased risk of ventricular arrhythmias.
  • This finding can assist clinicians in optimizing the selection of patients for prophylactic ICD implantation to prevent sudden cardiac death.

Keywords:
implantable cardioverter defibrillatornon-ischemic dilated cardiomyopathyprimary preventionright bundle branch blocksudden cardiac death

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