Advanced search
1 file | 124.10 KB Add to list

The electrocardiographic characteristics of septal flash in patients with left bundle branch block

BEN CORTEVILLE (UGent) , Jan De Pooter (UGent) , Tine De Backer (UGent) , Milad El Haddad (UGent) , Roland Stroobandt (UGent) and Frank Timmermans (UGent)
(2017) EUROPACE. 19(1). p.103-109
Author
Organization
Abstract
Aims: In patients with systolic heart failure and left bundle branch block (LBBB), septal flash (SF) movement has been described by echocardiography. We evaluated the prevalence of SF in LBBB and non-LBBB patients and evaluated whether specific electrocardiographic (ECG) characteristics within LBBB are associated with the presence of SF on echocardiography. Methods and results: One hundred and four patients with probable LBBB on standard 12-lead ECG were selected, 40 patients with non-LBBB served as controls. Left bundle branch block and non-LBBB were defined, according to the most recent guidelines. The presence of SF was assessed by echocardiography. Strict LBBB criteria were met in 93.3% of the patients. Septal flash was present in 45.2% of LBBB patients and was not present in non-LBBB patients. This was more prevalent in patients without anterior ischaemic cardiomyopathy (ICMP) compared with those with anterior ICMP (P = 0.008). The duration of QRS was longer in SF patients compared with that of non-SF patients (P < 0.05). The presence of a mid-QRS notching in more than two consecutive leads was a good predictor for the presence of SF (P = 0.01), and when combined with an absent R-wave in lead V1, the presence of SF is very likely (P = 0.001). Conclusion: Our data show that SF is present in 45.2% of LBBB patients, whereas it was absent in patients with non-LBBB. Patients with SF fulfilled more LBBB criteria compared with LBBB patients without SF. Our findings raise the provocative question of whether the presence of SF identifies patients with 'true LBBB' and whether this echocardiographic finding might be considered as a selection parameter in cardiac resynchronization therapy.
Keywords
Left bundle branch block, Echocardiography, Septal flash, Cardiac resynchronization therapy, Dyssynchrony, CARDIAC RESYNCHRONIZATION THERAPY, HEART-FAILURE, ACTIVATION, ECHOCARDIOGRAPHY, CONTRACTION, REVERSE, TRIAL, RISK, CRT

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 124.10 KB

Citation

Please use this url to cite or link to this publication:

MLA
CORTEVILLE, BEN, Jan De Pooter, Tine De Backer, et al. “The Electrocardiographic Characteristics of Septal Flash in Patients with Left Bundle Branch Block.” EUROPACE 19.1 (2017): 103–109. Print.
APA
CORTEVILLE, B., De Pooter, J., De Backer, T., El Haddad, M., Stroobandt, R., & Timmermans, F. (2017). The electrocardiographic characteristics of septal flash in patients with left bundle branch block. EUROPACE, 19(1), 103–109.
Chicago author-date
CORTEVILLE, BEN, Jan De Pooter, Tine De Backer, Milad El Haddad, Roland Stroobandt, and Frank Timmermans. 2017. “The Electrocardiographic Characteristics of Septal Flash in Patients with Left Bundle Branch Block.” Europace 19 (1): 103–109.
Chicago author-date (all authors)
CORTEVILLE, BEN, Jan De Pooter, Tine De Backer, Milad El Haddad, Roland Stroobandt, and Frank Timmermans. 2017. “The Electrocardiographic Characteristics of Septal Flash in Patients with Left Bundle Branch Block.” Europace 19 (1): 103–109.
Vancouver
1.
CORTEVILLE B, De Pooter J, De Backer T, El Haddad M, Stroobandt R, Timmermans F. The electrocardiographic characteristics of septal flash in patients with left bundle branch block. EUROPACE. 2017;19(1):103–9.
IEEE
[1]
B. CORTEVILLE, J. De Pooter, T. De Backer, M. El Haddad, R. Stroobandt, and F. Timmermans, “The electrocardiographic characteristics of septal flash in patients with left bundle branch block,” EUROPACE, vol. 19, no. 1, pp. 103–109, 2017.
@article{7075186,
  abstract     = {Aims: In patients with systolic heart failure and left bundle branch block (LBBB), septal flash (SF) movement has been described by echocardiography. We evaluated the prevalence of SF in LBBB and non-LBBB patients and evaluated whether specific electrocardiographic (ECG) characteristics within LBBB are associated with the presence of SF on echocardiography. 
Methods and results: One hundred and four patients with probable LBBB on standard 12-lead ECG were selected, 40 patients with non-LBBB served as controls. Left bundle branch block and non-LBBB were defined, according to the most recent guidelines. The presence of SF was assessed by echocardiography. Strict LBBB criteria were met in 93.3% of the patients. Septal flash was present in 45.2% of LBBB patients and was not present in non-LBBB patients. This was more prevalent in patients without anterior ischaemic cardiomyopathy (ICMP) compared with those with anterior ICMP (P = 0.008). The duration of QRS was longer in SF patients compared with that of non-SF patients (P < 0.05). The presence of a mid-QRS notching in more than two consecutive leads was a good predictor for the presence of SF (P = 0.01), and when combined with an absent R-wave in lead V1, the presence of SF is very likely (P = 0.001). 
Conclusion: Our data show that SF is present in 45.2% of LBBB patients, whereas it was absent in patients with non-LBBB. Patients with SF fulfilled more LBBB criteria compared with LBBB patients without SF. Our findings raise the provocative question of whether the presence of SF identifies patients with 'true LBBB' and whether this echocardiographic finding might be considered as a selection parameter in cardiac resynchronization therapy.},
  author       = {CORTEVILLE, BEN and De Pooter, Jan and De Backer, Tine and El Haddad, Milad and Stroobandt, Roland and Timmermans, Frank},
  issn         = {1099-5129},
  journal      = {EUROPACE},
  keywords     = {Left bundle branch block,Echocardiography,Septal flash,Cardiac resynchronization therapy,Dyssynchrony,CARDIAC RESYNCHRONIZATION THERAPY,HEART-FAILURE,ACTIVATION,ECHOCARDIOGRAPHY,CONTRACTION,REVERSE,TRIAL,RISK,CRT},
  language     = {eng},
  number       = {1},
  pages        = {103--109},
  title        = {The electrocardiographic characteristics of septal flash in patients with left bundle branch block},
  url          = {http://dx.doi.org/10.1093/europace/euv461},
  volume       = {19},
  year         = {2017},
}

Altmetric
View in Altmetric
Web of Science
Times cited: