Premium
Distinct left bundle branch block pattern in ischemic and non‐ischemic dilated cardiomyopathy
Author(s) -
BayesGenis Antoni,
Lopez Laura,
Viñolas Xavier,
Elosua Roberto,
Brossa Vicenç,
Campreciós Marta,
Mateo Miriam,
Cinca Juan,
Luna Antonio Bayes
Publication year - 2003
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/s1388-9842(02)00203-9
Subject(s) - medicine , left bundle branch block , cardiology , ischemic cardiomyopathy , dilated cardiomyopathy , cardiomyopathy , electrocardiography , heart failure , ejection fraction
Background: A high percentage of patients with dilated cardiomyopathy have the electrocardiographic (ECG) pattern of advanced left bundle branch block (LBBB). In the present study we sought to investigate whether patients with dilated cardiomyopathy of ischemic or non‐ischemic etiology can be differentiated on the basis of LBBB pattern. Methods and Results: The study population included 41 patients with dilated cardiomyopathy of non‐ischemic (NIC) ( n =26) or ischemic origin (IC) ( n =15) and LBBB on surface ECG. ECG duration and voltage were digitally measured. The presence of notching of S wave in right precordial leads ( V 1– V 3) was not statistically different between the groups. The voltages of precordial leads V 2, V 3 and the Σ( V 1+ V 2+ V 3 voltages) were significantly more prominent in patients with NIC ( P =0.002, P <0.001 and P =0.002, respectively). The discriminative power of receiver operating characteristic analysis was best at voltages of V 3 of 2100 μV (area under the curve, 0.805; standard error, 0.001). The sensitivity and specificity of V 3 voltage >2100 μV on surface ECG in the presence of LBBB to identify a cardiomyopathy of non‐ischemic origin were 85 and 73%, respectively. Conclusions: A single ECG criteria, voltage of lead V 3, appears to be a useful parameter to identify patients with dilated cardiomyopathy of ischemic or non‐ischemic origin in the presence of advanced LBBB.