Comparison of the electrocardiographic features of complete left bundle branch block in patients with ischemic and nonischemic left ventricular dysfunction.
BACKGROUND
Differentiating ischemic (ILVD) from nonischemic left ventricular dysfunction (NILVD) is important prognostically and therapeutically but might be difficult clinically. The differentiating role of electrocardiographic (ECG) features in the presence of left bundle-branch block (LBBB) is debatable on differentiating ILVD from NILVD.


OBJECTIVE
The present study assessed whether there is the role of certain ECG features in differentiating ILVD from NILVD in the presence of the complete LBBB.


RESULTS
Patients who had LBBB were divided into two groups based on the presence and type of left ventricular dysfunction; (1) ILVD group (49 patients; 20 female; age: 65 +/- 11 years) and (2) NILVD group (49 patients; 22 female; age: 59 +/- 12 years), and numerous ECG features were compared. Most of these ECG features did not show any difference between the groups except for following ECG findings; the voltage of R wave in V6 were statistically higher in NILVD group compared ILVD group (p: 0.03); the depression of the ST-J point by more than 0.2 mV in V6 were also frequently observed in NILVD group compared ILVD group (5/ 10% vs 19/ 39% , p: 0.001); and the notching in the ascending or descending limb of the S wave in V1-4 leads were more in ILVD group (18/ 36% vs 8/ 16% p: 0.03; 9/ 16% vs 2/ 4%, p: 0.03, respectively).


CONCLUSIONS
In the current study, although some ECG findings were found to be useful, ECG features in the presence of complete LBBB had poor value in differentiating ILVD from NILVD.
Deveci
Bulent
B
Yuksek Ihtisas Education and Research Hospital, Cardiology, Ankara, Turkey.
Ozeke
Ozcan
O
Ozlu
Mehmet Fatih
MF
Gurel
Ozgul Malcok
OM
Selcuk
Mehmet Timur
MT
Topaloglu
Serkan
S
Maden
Orhan
O
Ergun
Kumral
K
Canga
Aytun
A
Guler
Tumer Erdem
TE
Kaya
Veli
V
Aras
Dursun
D