title: Right bundle branch block and ventricular septal fibrosis in patients with hypertrophic cardiomyopathy.
abstract: BACKGROUND
  Right bundle branch block (RBBB) is associated with ventricular septal fibrosis in patients with hypertrophic cardiomyopathy (HCM) after alcohol septal ablation, but little data are available in HCM patients without a history of septal ablation.
  
  
  METHODS
  Magnetic resonance late gadolinium enhancement (LGE) was performed in 59 HCM patients with no history of alcohol septal ablation. The location and extent of LGE were examined in relation to electrocardiographic features including RBBB.
  
  
  RESULTS
  LGE volume was higher in 7 HCM patients with RBBB (7.3±7.4g/cm) than in patients without RBBB (2.9±7.4g/cm, p=0.016). LGE volume was positively correlated to QRS duration of RBBB (correlation coefficient=0.93, p=0.023). The diagnostic value of RBBB was highly specific for the detection of LGE in the ventricular septum, with sensitivity 21% and specificity 94%.
  
  
  CONCLUSIONS
  The presence of RBBB may be a simple marker for detecting ventricular septal fibrosis in HCM patients who had no history of alcohol septal ablation. Further studies are necessary to confirm our findings.
authors.affiliation: Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan. Electronic address: harimoto.kuniyasu@jp.panasonic.com.
authors.forename: Kuniyasu
authors.initials: K
authors.lastname: Harimoto
authors.affiliation: Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kawasaki
authors.affiliation: Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan.
authors.forename: Sakiko
authors.initials: S
authors.lastname: Honda
authors.affiliation: Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Miki
authors.affiliation: Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan.
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Kamitani
mesh_terms: D000368:Aged; D002037:Bundle-Branch Block / Q000209:etiology* / Q000503:physiopathology; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000503:physiopathology; D003287:Contrast Media; D004562:Electrocardiography; D005260:Female; D005355:Fibrosis / Q000150:complications / Q000503:physiopathology; D006346:Heart Septum / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Hypertrophic cardiomyopathy; Myocardial fibrosis; Right bundle branch block; Ventricular septum