Non-invasive assessment of coronary artery disease in patients with left bundle branch block

Mordi, Ify; Tzemos, Nikolaos

doi:10.1016/j.ijcard.2015.01.084

Cited by 10 publications

(4 citation statements)

References 62 publications

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“…This research also showed that patients with CLBBB experienced a high recurrence rate despite of early improvement after steroid treatment, and their cardiac function could decrease, accompanied with enlarging left ventricle. This might result from the damage of left ventricular systolic function and myocardial synchronize movement by CLBBB [ 30 , 31 ]. In this study, one patient died of heart failure and another died of impaired cardiac function.…”

Section: Discussionmentioning

confidence: 99%

The Long-Term Change of Arrhythmias after Transcatheter Closure of Perimembranous Ventricular Septal Defects

Zheng

Lin

Wang

et al. 2021

Cardiology Research and Practice

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Objectives. To observe and analyze the long-term change of different types of arrhythmias after transcatheter closure of perimembranous ventricular septal defect (pmVSD). Methods. We retrospectively collected the data of patients who underwent pmVSD closure in our institution from March 2002 to December 2010. Results. One hundred thirty-nine patients met the inclusion criteria, of which 265 (25.5%) had early arrhythmia. They were classified into two categories: conduction abnormality (191/1039; 18.4%) and origin abnormality (94/1039; 9.0%), including 20 patients with both types of arrhythmias. The median follow-up time was 84.5 months, and 103 patients (103/191; 53.9%) with early conduction block got permanent arrhythmias, while only three patients (3/94; 3.2%) with early anomalous origin arrhythmias still had an abnormal electrocardiogram. Serious arrhythmias (28/1039; 2.7%), including II° atrioventricular block (AVB), III° AVB, and complete left bundle branch block (CLBBB), can appear immediately in the early postoperative period (21 patients) or in the late outset (seven patients) after several months or even years (6 months to 8.3 years). Twenty patients (20/21; 95.2%) with serious arrhythmia in the early postoperative period improved after early treatment, but six patients relapsed or worsened during follow-up. At the endpoint, severe arrhythmia persisted in 13 patients, of which four patients got permanent pacemaker implanted, and one patient with recurrent CLBBB died from heart failure. Conclusions. The probability of delayed CAVB or bundle branch block after VSD closure is low but often occurs several years after surgery. Therefore, long-term ECG follow-up should last for several years or even decades. Serious arrhythmias that appear early after transcatheter pmVSD closure may impose a risk of recurrence although they have been cured already. Close attention should be paid to the changes of cardiac function in patients with CLBBB after VSD closure, and the severity of such arrhythmia should be taken seriously and reexamined.

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Section: Discussionmentioning

confidence: 99%

The Long-Term Change of Arrhythmias after Transcatheter Closure of Perimembranous Ventricular Septal Defects

Zheng

Lin

Wang

et al. 2021

Cardiology Research and Practice

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“…2,18 Despite the plethora of evidence for the use of the ETT, there are a number of patients who are unable to achieve a diagnostic test, while many others may be unable to undergo the test at all, either due to immobility or resting ECG abnormalities that may preclude evaluation of the test such as left bundle branch block. 19,20 Given this, it would be useful to have an alternative risk-stratification strategy in this group of patients.…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of CT coronary angiography in patients attending hospital with troponin-negative acute chest pain and inconclusive exercise treadmill tests

Mordi

Tzemos

2015

Eur Heart J Cardiovasc Imaging

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“…640,1150,[1159][1160][1161][1162][1163] If the patient has left bundle branch block or ventricular pacing, exercise/pharmacological stress radionuclide imaging or echocardiography is recommended. 1164,1165 b. If Exercise Is Impossible Pharmacological stress radionuclide imaging or echocardiography is recommended for patients with chronic coronary heart disease who cannot perform adequate exercise, irrespective of whether ECG changes are diagnostic or not.…”

Section: ▋ 422 Assessment Of Cardiac Function With Stress Loading Amentioning

confidence: 99%

JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases

Yamagishi¹,

Tamaki²,

Akasaka³

et al. 2021

Circ J

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ABI ankle-brachial index ACC American College of Cardiology ACS acute coronary syndrome AHA American Heart Association APV averaged peak velocity ARH autosomal recessive hypercholesterolemia AS Agatston score ASO arteriosclerosis obliterans ATP adenosine triphosphate BMIPP β-methyl-p-iodophenyl-pentadecanoic acid BNP B-type natriuretic peptide CABG coronary artery bypass grafting CACS coronary artery calcium score CAD coronary artery disease CANM Canadian Association of Nuclear Medicine CanSCMR Canadian Society of Cardiovascular Magnetic Resonance CAR Canadian Association of Radiologists CCS Canadian Cardiovascular Society CCTA coronary CT angiography CDC Centers for Disease Control and Prevention CFR coronary flow reserve CFVR coronary flow velocity reserve CI confidence interval CKD chronic kidney disease CNCS Canadian Nuclear Cardiology Society CPAP continuous positive airway pressure CT computed tomography CTA computed tomography angiography CTDIvol computed omography dose index volume ▋ 2.2.1 Selection of the Lead System and Recording Time Appropriate ECG recording is essential for making a diagnosis of coronary heart disease. Care should be exercised with regard to selection of the electrodes, leads, paste, and lead system to obtain stable recordings during daily activities. The leads that are most likely to reflect ischemic changes are V5-like leads. In particular, lead CM5 is less affected by body movements and has a good detection rate for ischemic changes. 50 A 2-lead system is commonly used, and the AHA guidelines recommend a combination of leads that approximates leads V1 and V5. 51 For capturing ST elevation in patients with variant angina, vertical leads (II, III, and aVF) and approximations to lead V2 or V3 provide a high diagnostic rate. 52 Both circadian and diurnal (dayto-day) variations may exist in relation to the incidence and duration of myocardial ischemia and the extent of ST changes. However, it is difficult to evaluate the influence of diurnal variation based on 24-hour recording, which means that 48-hour recording is desirable for detecting myocardial ischemia and determining the response to treatment. ▋ 2.2.2 Criteria for ST-Segment Changes The diagnostic significance of persistent ST depression on Holter ECG is not high. Rather, detection and evaluation of transient ST-segment changes is more important. The criteria for ST depression are as follows: (1) horizontal or sagging depression of the ST segment by ≥0.1 mV; (2) reaching maximum ST depression after 1 min; and (3) ST depression of ≥0.1 mV lasting for ≥30-60 s compared with the baseline in a controlled state. 49,53-55 ST depression is measured at 0.08 s after the S or J point, and J-type ST depression is not judged to be ischemic ST depression. 52 When counting the number of ischemic episodes, the definition adopted is that each ischemic interval should last for at least 1 min. 56 The criterion for ST elevation is elevation of the ST segment by ≥0.1 mV lasting for ≥30-60 s in leads without Q waves. 49 In patients with chest pain ...

show abstract

Non-invasive assessment of coronary artery disease in patients with left bundle branch block

Cited by 10 publications

References 62 publications

The Long-Term Change of Arrhythmias after Transcatheter Closure of Perimembranous Ventricular Septal Defects

The Long-Term Change of Arrhythmias after Transcatheter Closure of Perimembranous Ventricular Septal Defects

The prognostic value of CT coronary angiography in patients attending hospital with troponin-negative acute chest pain and inconclusive exercise treadmill tests

JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases

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