Complete right bundle branch block and QRS-T discordance can be the initial clue to detect S-ICD ineligibility

Motomi Tachibana, Nobuhiro Nishii, Yoshimasa Morimoto, Satoshi Kawada, Akihito Miyoshi, Hiroyasu Sugiyama, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: In order to minimize inappropriate shocks of subcutaneous implantable cardioverter-defibrillators (S-ICD), it is important to recognize who is suitable for S-ICD indication. This study aimed to clarify what types of cardiac disease are likely to fulfill the S-ICD screening criteria and ineligible factors for S-ICD in the standard 12-lead electrocardiogram (ECG). Methods: A total of 348 patients with heart disease were enrolled. They were assessed by supine and standing ECG recording to simulate the 3 S-ICD sensing vectors and standard 12-lead ECG, simultaneously. Clinical and ECG characteristics were analyzed to compare the patients who are eligible and ineligible with S-ICD screening ECG indication. Results: The mean age of study patients was 49. ±. 21 years and 244 (70%) were men. Nineteen percent of patients were unsuitable for S-ICD. There was no significant difference in ineligibility for S-ICD among cardiac diseases (p = 0.48). Univariate analysis showed complete right bundle branch block (CRBBB), QRS-T discordance in lead II, and QRS-T discordance in 3 leads (I, II, and aVF) were more frequent in patients who were ineligible for S-ICD than in the eligible group. Multivariate regression analysis showed CRBBB and QRS-T discordance in 3 leads were independent predictors for ineligibility of S-ICD. Conclusion: There are no differences in eligibility of S-ICD among types of cardiac diseases. CRBBB and QRS-T discordance were independent predictors for ineligibility.

Original languageEnglish
JournalJournal of Cardiology
DOIs
Publication statusAccepted/In press - Sep 22 2016

Fingerprint

Bundle-Branch Block
Implantable Defibrillators
Electrocardiography
Heart Diseases
Shock
Multivariate Analysis
Regression Analysis

Keywords

  • Implantable cardioverter-defibrillator
  • Sudden cardiac death
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{c8ed5847e79a4e08ac9c2bed735f434e,
title = "Complete right bundle branch block and QRS-T discordance can be the initial clue to detect S-ICD ineligibility",
abstract = "Background: In order to minimize inappropriate shocks of subcutaneous implantable cardioverter-defibrillators (S-ICD), it is important to recognize who is suitable for S-ICD indication. This study aimed to clarify what types of cardiac disease are likely to fulfill the S-ICD screening criteria and ineligible factors for S-ICD in the standard 12-lead electrocardiogram (ECG). Methods: A total of 348 patients with heart disease were enrolled. They were assessed by supine and standing ECG recording to simulate the 3 S-ICD sensing vectors and standard 12-lead ECG, simultaneously. Clinical and ECG characteristics were analyzed to compare the patients who are eligible and ineligible with S-ICD screening ECG indication. Results: The mean age of study patients was 49. ±. 21 years and 244 (70{\%}) were men. Nineteen percent of patients were unsuitable for S-ICD. There was no significant difference in ineligibility for S-ICD among cardiac diseases (p = 0.48). Univariate analysis showed complete right bundle branch block (CRBBB), QRS-T discordance in lead II, and QRS-T discordance in 3 leads (I, II, and aVF) were more frequent in patients who were ineligible for S-ICD than in the eligible group. Multivariate regression analysis showed CRBBB and QRS-T discordance in 3 leads were independent predictors for ineligibility of S-ICD. Conclusion: There are no differences in eligibility of S-ICD among types of cardiac diseases. CRBBB and QRS-T discordance were independent predictors for ineligibility.",
keywords = "Implantable cardioverter-defibrillator, Sudden cardiac death, Ventricular arrhythmia",
author = "Motomi Tachibana and Nobuhiro Nishii and Yoshimasa Morimoto and Satoshi Kawada and Akihito Miyoshi and Hiroyasu Sugiyama and Koji Nakagawa and Atsuyuki Watanabe and Kazufumi Nakamura and Hiroshi Morita and Hiroshi Ito",
year = "2016",
month = "9",
day = "22",
doi = "10.1016/j.jjcc.2016.11.014",
language = "English",
journal = "Journal of cardiography. Supplement",
issn = "0914-5087",
publisher = "Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)",

}

TY - JOUR

T1 - Complete right bundle branch block and QRS-T discordance can be the initial clue to detect S-ICD ineligibility

AU - Tachibana, Motomi

AU - Nishii, Nobuhiro

AU - Morimoto, Yoshimasa

AU - Kawada, Satoshi

AU - Miyoshi, Akihito

AU - Sugiyama, Hiroyasu

AU - Nakagawa, Koji

AU - Watanabe, Atsuyuki

AU - Nakamura, Kazufumi

AU - Morita, Hiroshi

AU - Ito, Hiroshi

PY - 2016/9/22

Y1 - 2016/9/22

N2 - Background: In order to minimize inappropriate shocks of subcutaneous implantable cardioverter-defibrillators (S-ICD), it is important to recognize who is suitable for S-ICD indication. This study aimed to clarify what types of cardiac disease are likely to fulfill the S-ICD screening criteria and ineligible factors for S-ICD in the standard 12-lead electrocardiogram (ECG). Methods: A total of 348 patients with heart disease were enrolled. They were assessed by supine and standing ECG recording to simulate the 3 S-ICD sensing vectors and standard 12-lead ECG, simultaneously. Clinical and ECG characteristics were analyzed to compare the patients who are eligible and ineligible with S-ICD screening ECG indication. Results: The mean age of study patients was 49. ±. 21 years and 244 (70%) were men. Nineteen percent of patients were unsuitable for S-ICD. There was no significant difference in ineligibility for S-ICD among cardiac diseases (p = 0.48). Univariate analysis showed complete right bundle branch block (CRBBB), QRS-T discordance in lead II, and QRS-T discordance in 3 leads (I, II, and aVF) were more frequent in patients who were ineligible for S-ICD than in the eligible group. Multivariate regression analysis showed CRBBB and QRS-T discordance in 3 leads were independent predictors for ineligibility of S-ICD. Conclusion: There are no differences in eligibility of S-ICD among types of cardiac diseases. CRBBB and QRS-T discordance were independent predictors for ineligibility.

AB - Background: In order to minimize inappropriate shocks of subcutaneous implantable cardioverter-defibrillators (S-ICD), it is important to recognize who is suitable for S-ICD indication. This study aimed to clarify what types of cardiac disease are likely to fulfill the S-ICD screening criteria and ineligible factors for S-ICD in the standard 12-lead electrocardiogram (ECG). Methods: A total of 348 patients with heart disease were enrolled. They were assessed by supine and standing ECG recording to simulate the 3 S-ICD sensing vectors and standard 12-lead ECG, simultaneously. Clinical and ECG characteristics were analyzed to compare the patients who are eligible and ineligible with S-ICD screening ECG indication. Results: The mean age of study patients was 49. ±. 21 years and 244 (70%) were men. Nineteen percent of patients were unsuitable for S-ICD. There was no significant difference in ineligibility for S-ICD among cardiac diseases (p = 0.48). Univariate analysis showed complete right bundle branch block (CRBBB), QRS-T discordance in lead II, and QRS-T discordance in 3 leads (I, II, and aVF) were more frequent in patients who were ineligible for S-ICD than in the eligible group. Multivariate regression analysis showed CRBBB and QRS-T discordance in 3 leads were independent predictors for ineligibility of S-ICD. Conclusion: There are no differences in eligibility of S-ICD among types of cardiac diseases. CRBBB and QRS-T discordance were independent predictors for ineligibility.

KW - Implantable cardioverter-defibrillator

KW - Sudden cardiac death

KW - Ventricular arrhythmia

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U2 - 10.1016/j.jjcc.2016.11.014

DO - 10.1016/j.jjcc.2016.11.014

M3 - Article

C2 - 28034575

AN - SCOPUS:85009174962

JO - Journal of cardiography. Supplement

JF - Journal of cardiography. Supplement

SN - 0914-5087

ER -