Document Detail


Complete left bundle branch block with left QRS axis deviation: defining its clinical importance.
MedLine Citation:
PMID:  9217920     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aim of this study was to elucidate the diagnostic significance of left axis deviation (LAD) in patients (pts) with chronic (> 6 months) left bundle branch block (LBBB). We retrospectively studied 2094 consecutive pts who underwent cardiac catheterization. All pts had left heart catheterization and coronary angiography, whereas right heart catheterization or endomyocardial biopsy were performed on indication. Our study group consisted of 43 pts with LBBB (29 men, 14 women, mean age 60.3 +/- 7.9 years). Pts with acute myocardial infarction or prior high degree AV-block were excluded. Initial evaluation included history, physical examination, chest X-ray, serial ECGs, 2D-echo and Doppler studies. ECG-criteria for LBBB were a QRS duration of > 0.12 secs, a predominantly negative QRS deflection in V1 and a widened R-wave in V6. LAD was considered present when the mean frontal QRS axis was between -30 degrees and -90 degrees. The mean frontal QRS axis was considered normal if it was between -29 degrees and +90 degrees. Twenty-nine pts had normal axis and 14 had LAD. According to angiographic data, among coronary disease pts, 12 (31.48%) had normal axis and 4 (28.57%) LAD (p = 0.041). Among mitral valve disease pts, 3 (10.35%) had normal axis and none LAD. Among pts with aortic valve disease, I (3.45%) had normal axis and 8 (57.15%) LAD (p = 0.0001). Among pts with dilated cardiomyopathy, 2 (6.9%) had normal axis and 1 (7.14%) LAD. Among pts with no organic heart disease, 11 (37.93%) had normal axis and 1 (7.14%) LAD (p = 0.035). The presence of LAD had a 41.9% sensitivity and a 91.6% specificity for the presence of organic heart disease. These findings point towards a statistically significant difference in the presence of organic heart disease in LBBB pts with LAD compared to normals. Aortic valve disease in LBBB pts seems to be frequently accompanied by LAD.
Authors:
G Parharidis; J Nouskas; G Efthimiadis; J Styliadis; K Gemitzis; S Hatzimiltiadis; T Karoulas; D Tsifodimos
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  52     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  1997  
Date Detail:
Created Date:  1997-08-25     Completed Date:  1997-08-25     Revised Date:  2009-06-11    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  BELGIUM    
Other Details:
Languages:  eng     Pagination:  295-303     Citation Subset:  IM    
Affiliation:
1st Department of Cardiology, AHEPA General Hospital, Medical School, Aristotle University of Thessaloniki, Greece.
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MeSH Terms
Descriptor/Qualifier:
Aged
Bundle-Branch Block / diagnosis*
Case-Control Studies
Coronary Angiography
Electrocardiography*
Female
Heart Catheterization
Heart Diseases / diagnosis*
Humans
Male
Middle Aged
Retrospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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