Right bundle branch block and risk of cardiovascular mortality: the Ibaraki Prefectural Health Study

Nakazawa, Naomi; Ishizu, Tomoko; Sairenchi, Toshimi; Yamagishi, Kazumasa; Murakoshi, Nobuyuki; Nakagawa, Daishi; Nakatsukasa, Tomofumi; Kawamatsu, Naoto; Sato, Kimi; Yamamoto, Masayoshi; Machino-Otsuka, Tomoko; Xu, DongZhu; Irie, Fujiko; Tomizawa, Takuji; Nogami, Akihiko; Aonuma, Kazutaka; Iso, Hiroyasu; Ieda, Masaki; Kawakami, Yasushi; Ota, Hitoshi

doi:10.1007/s00380-021-01944-6

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…(Miller et al, 2008;Movahed, 2007;Yano et al, 2021) In a recent large community-based cohort study of 90,022 individuals aged 40-79 years who participated in annual community-based health check-ups, the prevalence of CRBBB was 1.5%. (Nakazawa et al, 2021) In our study, the prevalence of CRBBB was also 1.5%, but our study population included patients aged <40 years, all of whom were hospitalized at the Heart Center of Henan Provincial People's Hospital and the majority of whom had cardiovascular diseases.…”

Section: Discussionmentioning

confidence: 90%

“…(Eriksson, Hansson, Eriksson, & Dellborg, 1998 ; Fahy et al, 1996 ; Fleg et al, 1983 ) However, these findings are based on a few outdated studies with small sample sizes, and many recent cohort studies have found that CRBBB is significantly associated with cardiovascular risk and all‐cause mortality. (Bussink et al, 2013 ; Cinca et al, 2013 ; Kleemann et al, 2008 ; Manzano et al, 2011 ; McCullough et al, 2005 ; Nakazawa et al, 2021 ; Widimsky et al, 2012 ; Wong et al, 2006 ) Furthermore, a recent study showed that CRBBB is an independent predictor of AF recurrence after pulmonary vein isolation. (Yano et al, 2021 ) In patients with CRBBB who have undergone AF ablation, most of the pathogenic factors for AF exist before ablation.…”

Section: Introductionmentioning

confidence: 99%

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Association between complete right bundle branch block and atrial fibrillation development

Zhang

Liu

Zhao

et al. 2022

Noninvasive Electrocardiol

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Atrial fibrillation (AF) is a common cardiac arrhythmia in the general population (Kjerpeseth et al., 2021) and is associated with increased cardiovascular morbidity and mortality. (Tanaka et al., 2021) Early recognition of AF could allow for more successful control of arrhythmia and protect the patient from adverse consequences. (Hindricks et al., 2021) Therefore, it is crucial to identify patients who are at an increased risk of developing AF. Complete right bundle branch block (CRBBB) is one of the most frequent alterations observed on

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Association between complete right bundle branch block and atrial fibrillation development

Zhang

Liu

Zhao

et al. 2022

Noninvasive Electrocardiol

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“…The impact of this non-physiological right physiological activation on cardiac function and long-term outcomes is unknown. The observation of adverse outcomes in patients with right bundle branch block led to concerns that non-physiological right ventricular activation during LBBP could adversely impact cardiac function 13,14 .…”

Section: Introductionmentioning

confidence: 99%

Left bundle branch pacing with and without anodal capture: impact on ventricular activation pattern and acute hemodynamics

Ali

Saqi

Miyazawa

et al. 2023

Preprint

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Introduction Left bundle branch pacing (LBBP) can deliver physiological left ventricular activation, but typically at the cost of delayed right ventricular (RV) activation. A proposed solution is to advance RV activation through anodal capture, but there is uncertainty regarding the mechanism by which early RV activation is achieved (capture of right bundle or RV myocardial capture) and it is not known whether this produces hemodynamic benefit. Methods We recruited patients with LBBP leads in whom anodal capture eliminated the terminal R wave in lead V1. Ventricular activation pattern, timing and high precision acute hemodynamic response were studied during LBBP with and without anodal capture. Results We recruited 21 patients, mean age 67 years, 14 were males. We measured ECG timings and hemodynamics in all patients and in 15 we also performed non-invasive mapping. Ventricular epicardial propagation maps demonstrated that right ventricular septal myocardial capture, rather than right bundle capture, was the mechanism for earlier RV activation. With anodal capture, QRS duration was shorter (116 ± 12ms versus 129 ± 14ms, p < 0.01), and total ventricular activation time was shorter (83 ± 18ms versus 90 ± 15ms, p = 0.01). This required higher outputs (3.6 ± 1.9V versus 0.6 ± 0.2V, p <0.01) but did not provide additional hemodynamic benefit (mean difference -0.2 ± 3.8 mmHg compared to pacing without anodal capture, p = 0.2). Conclusion Left bundle pacing with anodal capture advances right ventricular activation as a result of stimulation of the RV septal myocardium. However, this requires higher outputs and did not improve acute hemodynamics. Aiming for anodal capture may therefore not be necessary.

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“…The observation of adverse outcomes in patients with right bundle branch block led to concerns that non-physiological RV activation during LBBP could adversely impact cardiac function. 13 , 14 …”

Section: Introductionmentioning

confidence: 99%

Left bundle branch pacing with and without anodal capture: impact on ventricular activation pattern and acute haemodynamics

Ali,

Saqi,

Arnold

et al. 2023

Europace

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Aims Left bundle branch pacing (LBBP) can deliver physiological left ventricular activation, but typically at the cost of delayed right ventricular (RV) activation. Right ventricular activation can be advanced through anodal capture, but there is uncertainty regarding the mechanism by which this is achieved, and it is not known whether this produces haemodynamic benefit. Methods and results We recruited patients with LBBP leads in whom anodal capture eliminated the terminal R-wave in lead V1. Ventricular activation pattern, timing, and high-precision acute haemodynamic response were studied during LBBP with and without anodal capture. We recruited 21 patients with a mean age of 67 years, of whom 14 were males. We measured electrocardiogram timings and haemodynamics in all patients, and in 16, we also performed non-invasive mapping. Ventricular epicardial propagation maps demonstrated that RV septal myocardial capture, rather than right bundle capture, was the mechanism for earlier RV activation. With anodal capture, QRS duration and total ventricular activation times were shorter (116 ± 12 vs. 129 ± 14 ms, P < 0.01 and 83 ± 18 vs. 90 ± 15 ms, P = 0.01). This required higher outputs (3.6 ± 1.9 vs. 0.6 ± 0.2 V, P < 0.01) but without additional haemodynamic benefit (mean difference −0.2 ± 3.8 mmHg compared with pacing without anodal capture, P = 0.2). Conclusion Left bundle branch pacing with anodal capture advances RV activation by stimulating the RV septal myocardium. However, this requires higher outputs and does not improve acute haemodynamics. Aiming for anodal capture may therefore not be necessary.

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Right bundle branch block and risk of cardiovascular mortality: the Ibaraki Prefectural Health Study

Cited by 7 publications

References 27 publications

Association between complete right bundle branch block and atrial fibrillation development

Association between complete right bundle branch block and atrial fibrillation development

Left bundle branch pacing with and without anodal capture: impact on ventricular activation pattern and acute hemodynamics

Left bundle branch pacing with and without anodal capture: impact on ventricular activation pattern and acute haemodynamics

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