Noninvasive and invasive evaluation of left bundle branch block (LBBB).
Nineteen patients with LBBB were studied by clinical, electrocardiographic (ECG), echocardiographic, electrophysiological and coronary angiographic examination. The commonest etiology of LBBB observed was idiopathic/degenerative in 10 (52.6%), followed by atherosclerotic coronary artery disease in 6 (31.5%) and hypertrophic cardiomyopathy, dilated cardiomyopathy and systemic hypertension in 1 case each (15.7%). In all patients with coronary artery disease (CAD), significant lesion of the left anterior descending artery was observed. On ECG, presence of Q in I, aVL, V5 or V6 was most helpful in predicting the presence of CAD while primary T-wave changes were least helpful. The degree of QRS axis was not helpful in predicting the presence as well as severity of CAD. Altered septal/regional wall motion abnormalities were commonly encountered on echocardiography and left ventriculography. Although infrahisian conduction delay was frequently observed and 11 (61.1%) had prolonged HV interval, in 2 of these there was additional suprahisian conduction delay. All patients with prolonged PR interval (more than or equal to 200 msec) or wide QRS duration (more than 140 msec) had infrahisian block with or without associated suprahisian block. Hence, hemodynamic evaluation, coronary angiographic studies and electrophysiological evaluation is essential in patients with LBBB.
Shah
K D
KD
Department of Cardiology, T.N. Medical College, Bombay, India.
Daxini
B V
BV
D000328:Adult; D000368:Aged; D000792:Angiography; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D009202:Cardiomyopathies / Q000150:complications; D003327:Coronary Disease / Q000150:complications; D004452:Echocardiography; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies