右束支传导阻滞作为房间隔异常的一个标志。

Right bundle branch block as a marker for interatrial septal abnormalities.

作者信息

Bakalli Aurora, Koçinaj Dardan, Georgievska-Ismail Ljubica, Bekteshi Tefik, Pllana Ejup, Sejdiu Basri

机构信息

Department of Cardiology, Clinic of Internal Medicine, University Clinical Center of Kosova, Rr. Gazmend Zajmi nr. 23, Prishtina, Kosovo.

出版信息

Cardiol Young. 2012 Feb;22(1):18-25. doi: 10.1017/S1047951111000795. Epub 2011 Jun 23.

DOI:10.1017/S1047951111000795

PMID:21729501

Abstract

BACKGROUND

Interatrial septal anomalies, which include atrial septal defect, patent foramen ovale, and atrial septal aneurysm, are common disorders among adult patients. Early detection of interatrial septal anomalies is important in order to prevent haemodynamic consequences and/or thromboembolic events. Electrocardiogram offers some clues that should serve as hints for detection of interatrial abnormalities. The aim of our study was to analyse the interatrial septum by transoesophageal echocardiography in patients with electrocardiogram signs of right bundle branch block and in those without right bundle branch block.

METHODS AND RESULTS

In a prospective study, 87 adult patients were included, that is, 41 with electrocardiogram signs of right bundle branch block forming the first group and 46 without right bundle branch block forming the second group. Interatrial septal anomalies were present in 80.5% of the patients with right bundle branch block, with patent foramen ovale (39.02%) being the most prevalent disorder, followed by atrial septal aneurysm (21.9%) and atrial septal defect (19.5%). Interatrial septal abnormalities were significantly more frequent in the first group compared with the second group (80.5% versus 6.5%, p value less than 0.001). Independently, patent foramen ovale was significantly more prevalent in patients with right bundle branch block (39.02% versus 4.3%, p value less than 0.001), as were atrial septal aneurysm (21.9% versus 2.2%, p value equal 0.01) and atrial septal defect (19.5% versus 0%, p value equal 0.004).

CONCLUSIONS

Right bundle branch block should serve as a valuable indicator to motivate a detailed search for interatrial septal abnormalities.

摘要

背景

房间隔异常，包括房间隔缺损、卵圆孔未闭和房间隔瘤，是成年患者中的常见疾病。早期发现房间隔异常对于预防血流动力学后果和/或血栓栓塞事件很重要。心电图提供了一些线索，应作为检测房间隔异常的提示。我们研究的目的是通过经食管超声心动图分析有右束支传导阻滞心电图表现的患者和无右束支传导阻滞的患者的房间隔情况。

方法和结果

在一项前瞻性研究中，纳入了87名成年患者，即41名有右束支传导阻滞心电图表现的患者组成第一组，46名无右束支传导阻滞的患者组成第二组。有右束支传导阻滞的患者中80.5%存在房间隔异常，其中卵圆孔未闭（39.02%）是最常见的疾病，其次是房间隔瘤（21.9%）和房间隔缺损（19.5%）。与第二组相比，第一组房间隔异常明显更常见（80.5%对6.5%，p值小于0.001）。单独来看，卵圆孔未闭在有右束支传导阻滞的患者中明显更常见（39.02%对4.3%，p值小于0.001），房间隔瘤（21.9%对2.2%，p值等于0.01）和房间隔缺损（19.5%对0%，p值等于0.004）也是如此。