title: Reservations about the Selvester QRS score in left bundle branch block - Experience in patients with transcatheter aortic valve implantation.
abstract: The Selvester QRS score (S-score) estimates myocardial scar using electrocardiographic criteria. We evaluated the S-score for left bundle branch block (LBBB).
  
  
  
  Studied were 36 patients who developed persistent LBBB upon transcatheter aortic valve implantation (TAVI, TAVI-LBBB group) and 36 matched patients with persistent narrow QRS (TAVI-nQRS group). Electrocardiograms were recorded before and briefly after TAVI and during ~6months follow-up. S-score was calculated using criteria for hypertrophic (in absence of LBBB) or LBBB hearts.
  
  
  
  In TAVI-LBBB patients correlation between S-scores pre-TAVI and post-TAVI was absent (R2=0.023). High S-scores post-TAVI occurred in patients with low pre-TAVI scores. Pre-post TAVI scores correlated weakly in TAVI-nQRS (R2=0.182), indicating a possible influence of ventricular unloading by TAVI. In both groups S-scores at post-TAVI and follow-up compared reasonably (R2=0.389 and R2=0.386), indicating reproducibility in more stable conditions.
  
  
  
  This study indicates that the use of the LBBB S-score criteria overestimates scar size and that caution is recommended in the use of the score in patients with LBBB.
authors.affiliation: Department of Cardiothoracic Surgery, Maastricht University Medical Center, PO Box 5800, Maastricht, The Netherlands.
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Poels
authors.affiliation: Department of Cardiothoracic Surgery, Maastricht University Medical Center, PO Box 5800, Maastricht, The Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Kats
authors.affiliation: Department of Cardiology, Maastricht University Medical Center, PO Box 5800, Maastricht, The Netherlands.
authors.forename: Leo
authors.initials: L
authors.lastname: Veenstra
authors.affiliation: Department of Cardiology, Maastricht University Medical Center, PO Box 5800, Maastricht, The Netherlands.
authors.forename: Vincent
authors.initials: V
authors.lastname: van Ommen
authors.affiliation: Department of Cardiothoracic Surgery, Maastricht University Medical Center, PO Box 5800, Maastricht, The Netherlands.
authors.forename: Jos G
authors.initials: JG
authors.lastname: Maessen
authors.affiliation: CARIM School for Cardiovascular Diseases, PO Box 616, Maastricht, The Netherlands. Electronic address: frits.prinzen@maastrichtuniversity.nl.
authors.forename: Frits W
authors.initials: FW
authors.lastname: Prinzen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000209:etiology*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017682:Myocardial Stunning / Q000175:diagnosis* / Q000209:etiology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
keywords: Electrocardiography; Left bundle branch block; Myocardial scar; Selvester QRS scoring; Transcatheter aortic valve implantation