完全性右束支阻滞与心房颤动发展的关系。
Association between complete right bundle branch block and atrial fibrillation development.
机构信息
Department of Cardiology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.
Heart Centre of Henan Provincial People's Hospital, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, China.
出版信息
Ann Noninvasive Electrocardiol. 2022 Jul;27(4):e12966. doi: 10.1111/anec.12966. Epub 2022 May 14.
BACKGROUND
Complete right bundle branch block (CRBBB) is an important predictor of atrial fibrillation (AF) recurrence after pulmonary vein isolation. However, the association between CRBBB and AF development remains unclear.
METHODS
We performed a retrospective study of 2639 patients (male, n = 1549; female, n = 1090; mean age, 58 ± 13 years). CRBBB was defined as a late R (R') wave in lead V or V with a slurred S wave in lead I and/or lead V with a prolonged QRS duration (≥120 ms).
RESULTS
Among the 2639 patients, CRBBB was detected in 40 patients (1.5%), and the prevalence of AF was 7.4% (196/2639). The proportion of patients with AF and CRBBB was higher than the proportion of patients with AF without CRBBB (22.5% vs. 7.2%; p = 0.001). In the forward multivariate logistic analysis, CRBBB (odds ratio [OR], 3.329; 95% confidence interval [CI], 1.350-8.211; p = 0.009), complete left bundle branch block (OR, 2.209; 95% CI, 1.238-3.940; p = 0.007), age (OR, 1.020; 95% CI, 1.005-1.035; p = 0.009), valvular heart disease (OR, 2.332; 95% CI, 1.531-3.552; p < 0.001), left atrial diameter (OR, 1.133; 95% CI, 1.104-1.163; p < 0.001), left ventricular ejection fraction (OR, 1.023; 95% CI, 1.006-1.041; p = 0.007), and class I or III anti-arrhythmic drug use (OR, 10.534; 95% CI, 7.090-15.651; p < 0.001) were associated with AF.
CONCLUSION
Complete right bundle branch block was significantly associated with AF development in hospitalized patients with cardiovascular diseases.
背景
完全性右束支阻滞（CRBBB）是肺静脉隔离后心房颤动（AF）复发的重要预测因素。然而，CRBBB 与 AF 发展之间的关系仍不清楚。
方法
我们对 2639 例患者（男性，n=1549；女性，n=1090；平均年龄，58±13 岁）进行了回顾性研究。CRBBB 定义为 V 或 V 导联中晚期 R（R'）波，I 导联和/或 V 导联中 S 波模糊，QRS 时限延长（≥120ms）。
结果
在 2639 例患者中，40 例（1.5%）检测到 CRBBB，AF 的患病率为 7.4%（196/2639）。有 AF 和 CRBBB 的患者比例高于无 CRBBB 的 AF 患者比例（22.5%比 7.2%；p=0.001）。在向前逐步多元逻辑分析中，CRBBB（比值比[OR]，3.329；95%置信区间[CI]，1.350-8.211；p=0.009）、完全性左束支阻滞（OR，2.209；95%CI，1.238-3.940；p=0.007）、年龄（OR，1.020；95%CI，1.005-1.035；p=0.009）、瓣膜性心脏病（OR，2.332；95%CI，1.531-3.552；p<0.001）、左心房直径（OR，1.133；95%CI，1.104-1.163；p<0.001）、左心室射血分数（OR，1.023；95%CI，1.006-1.041；p=0.007）和 I 类或 III 类抗心律失常药物的使用（OR，10.534；95%CI，7.090-15.651；p<0.001）与 AF 相关。
结论
完全性右束支阻滞与住院心血管疾病患者 AF 的发生显著相关。
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