Effects of an Isolated Complete Right Bundle Branch Block on Mechanical Ventricular Function

Zhang, Qin; Meng, Xue; Zhan, Li; Wang, Haiyan; Zhu, Lei; Liu, Xinling; Meng, Hua; Hou, Yinglong

doi:10.7863/ultra.14.10069

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…However, Zhang Q. et al disagree with our result, as they report that RV FAC was no statistically significant difference between RBBB and control group. 20 This study also demonstrates statistically significant higher mean value of Pulse Doppler MPI in CRBBB as compare to IRBBB patients (P<0.001). Pulse Doppler MPI or Tei index is parameter use to measured RV function and it is affected by both diastolic and systolic function, as pulse Doppler MPI is directly proportional to the isovolumetric contraction time and isovolumic relaxation time and is inversely proportional to the ejection time.…”

Section: Discussionsupporting

confidence: 64%

Morphologic Characteristics and Function of Right Ventricle in Patients With Isolated Right Bundle Branch Block

Murtuza¹,

Regmi²,

Dhital³

et al. 2022

JCMC

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Background: The prevalence of right bundle branch block (RBBB) is estimated in 0.2 to 1.3% of healthy people. RBBB had independent association with decreased right ventricle (RV) function, which is considered as predictor of adverse cardiovascular outcomes. The aim of this study is to evaluate RV structure and function in patients with isolated RBBB (without structural heart disease) using two-dimensional echocardiography. Methods: A cross-sectional study conducted at Chitwan Medical College, Bharatpur from 1st January 2022 to 30th June 2022. Consecutive adult patients aged ≥18 years with isolated RBBB classified into complete RBBB (CRBBB) and Incomplete RBBB (IRBBB) based on electrocardiographic findings. The echocardiographic evaluation was done to assess RV dimension and function. Results: A total of 52 patients with isolated RBBB were included with mean age of the study population was 45.3 ± 9.3 years, (28 ,53.8%) had CRBBB, whereas the remaining (24, 46.2%) had IRBBB. Among the parameters used to assess RV function; mean RV-Fractional area change (P<0.001), Tricuspid annular plane systolic excursion(P<0.02) and Pulsed Doppler peak velocity at the lateral annulus RV(P<0.001) were significantly lower, while Pulsed Doppler myocardial performance index(P<0.001) was significantly high in CRBBB group as compared to IRBBB group. Similarly, Right atrium and RV dimensional parameters were significant higher in CRBBB compared to IRBBB group. Conclusions: Isolated RBBB is not as benign as it was considered and has deteriorating effect on RV morphology and function. Therefore, patients with Isolated RBBB need follow-up with passing age and more attention toward RV structural and functional analysis.

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Section: Discussionsupporting

confidence: 64%

Morphologic Characteristics and Function of Right Ventricle in Patients With Isolated Right Bundle Branch Block

Murtuza¹,

Regmi²,

Dhital³

et al. 2022

JCMC

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“…Abbreviations: ACS, acute coronary syndrome; AF, atrial fibrillation; DM, diabetes mellitus; HTN, hypertension; VHD, valvular heart disease. was found to be associated with impaired right ventricle function (12). LBBB, if present for a noticeable period of time, causes functional contraction disturbance.…”

Section: Discussionmentioning

confidence: 95%

Does Isolated Left Bundle Block Cause Heart Failure With Reduced Ejection Fraction? A Retrospective Cohort Study

Amirzadegan

Hosseini

Tajdini

et al. 2017

Thrita

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Background: Left bundle branch block (LBBB) is an important and independent determinant of mortality among patients with cardiovascular disease (CVD). Close follow-up and management of isolated LBBB to prevent cardiomyopathy is controversial. Methods: In this retrospective cohort study, patients with isolated LBBB, with no concomitant evident cardiac disease, or risk factors of heart failure with reduced EF such as hypertension or diabetes mellitus (DM) were included. The mean follow-up of the patients was 56 months. At the onset of the study, coronary angiogram and EF of the patients were normal. Patients with reduced EF underwent coronary angiogram at the end of their follow-up interval. Results: In this study, 36 patients, with the mean age 62.1 years (45-81) were followed. LV ejection fraction (EF) was reduced in 24 patients, and the other 11 patients continued to have a normal EF during the follow-up. The follow-up interval between the 2 groups was not statistically different (Mann-Whitney, P = 0.9). Most of the patients with reduced EF were male (Mann-Whitney, P = 0.01). New-onset HTN had a negative correlation with a decrease in EF% (Spearman correlation coefficient =-0.36, P = 0.031). Based on surface ECG parameters, 8 new notched-QRS were detected, all of which had decreased EF during follow-up. Conclusions: Not all patients with isolated LBBB develop cardiomyopathy at a definite time interval. Male gender, notched-QRS in ECG, and longevity of conduction delay are important predictors of cardiomyopathy among these patients. They may benefit from anti-remodeling drugs and routine close follow-ups with echocardiogram.

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“…The majority of evidence suggests that RBBB can cause delayed right ventricular electrical excitation and decreased right ventricular diastolic function. 10 Furthermore, this has little effect on left ventricular electrical excitation and left ventricular diastolic function. Therefore, the effect of RBBB on left ventricular function is still controversial.…”

Section: Discussionmentioning

confidence: 99%

The phenomenon of concealed conduction in a case of His bundle pacing (HBP)

2020

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The phenomenon of concealed conduction in His bundle pacing (HBP) has rarely been reported. We report here a patient who had 2: 1 atrioventricular block and complete left bundle branch block was used because of HBP. The patient developed continuous right bundle branch block after the operation. After excluding mechanical damage, we speculate that the mechanism of right bundle branch block in this case was due to concealed conduction.

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Effects of an Isolated Complete Right Bundle Branch Block on Mechanical Ventricular Function

Abstract: In patients with isolated complete right bundle branch blocks, systolic and diastolic functions are impaired in the RV, and follow-up is needed.

Cited by 6 publications

References 21 publications

Morphologic Characteristics and Function of Right Ventricle in Patients With Isolated Right Bundle Branch Block

Morphologic Characteristics and Function of Right Ventricle in Patients With Isolated Right Bundle Branch Block

Does Isolated Left Bundle Block Cause Heart Failure With Reduced Ejection Fraction? A Retrospective Cohort Study

The phenomenon of concealed conduction in a case of His bundle pacing (HBP)

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