Ventricular fibrillation associated with complete right bundle branch block

Yoshiyasu Aizawa, Seiji Takatsuki, Takehiro Kimura, Nobuhiro Nishiyama, Kotaro Fukumoto, Yoko Tanimoto, Kojiro Tanimoto, Shunichiro Miyoshi, Makoto Suzuki, Yasuhiro Yokoyama, Masaomi Chinushi, Ichiro Watanabe, Satoshi Ogawa, Yoshifusa Aizawa, Charles Antzelevitch, Keiichi Fukuda

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background A substantial number of patients with idiopathic ventricular fibrillation (IVF) present with no specific electrocardiographic (ECG) findings. Objective To evaluate complete right bundle branch block (RBBB) in patients with IVF. Methods Patients with IVF showing complete RBBB were included in the present study. Structural and primary electrical diseases were excluded, and provocation tests were performed to exclude the presence of spastic angina or Brugada syndrome (BrS). The prevalence of complete RBBB and the clinical and ECG parameters were compared either in patients with IVF who did not show RBBB or in the general population and age and sex comparable controls with RBBB. Results Of 96 patients with IVF, 9 patients were excluded for the presence of BrS. Of 87 patients studied, 10 (11.5%) patients showed complete RBBB. None had structural heart diseases, BrS, or coronary spasms. The mean age was 44 ± 15 years, and 8 of 10 patients were men. Among the ECG parameters, only the QRS duration was different from that of the other patients with IVF who did not show complete RBBB. Ventricular fibrillation recurred in 3:2 in the form of storms, which were well suppressed by isoproterenol. Complete RBBB was found less often in control subjects (1.37%; P <.0001), and the QRS duration was more prolonged in patients with IVF: 139 ± 10 ms vs 150 ± 14 ms (P =.0061). Conclusions Complete RBBB exists more often in patients with IVF than in controls. A prolonged QRS complex suggests a conduction abnormality. Our findings warrant further investigation of the role of RBBB in the development of arrhythmias in patients with IVF.

Original languageEnglish
Pages (from-to)1028-1035
Number of pages8
JournalHeart Rhythm
Volume10
Issue number7
DOIs
Publication statusPublished - 2013 Jul 1

Keywords

  • Brugada syndrome
  • Electrocardiogram
  • Idiopathic ventricular fibrillation
  • Right bundle branch block
  • Sudden death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Aizawa, Y., Takatsuki, S., Kimura, T., Nishiyama, N., Fukumoto, K., Tanimoto, Y., Tanimoto, K., Miyoshi, S., Suzuki, M., Yokoyama, Y., Chinushi, M., Watanabe, I., Ogawa, S., Aizawa, Y., Antzelevitch, C., & Fukuda, K. (2013). Ventricular fibrillation associated with complete right bundle branch block. Heart Rhythm, 10(7), 1028-1035. https://doi.org/10.1016/j.hrthm.2013.03.013