#Ivcd with lbbb manual#
The accuracy of the Minnesota coding and IVCD classification was checked by manual ECG analysis by three of the authors (JR, PH, and KN), blinded to the clinical outcome of the subject.
Left posterior fascicular block was defined as frontal QRS axis >120°, lead I rS configuration, leads II, III, and aVF qR configuration, and no pathological Q waves in leads II, III, aVF. For left anterior fascicular block we used the following definition: frontal QRS axis between –30° and –90°, rS configuration in II, III, and aVF, and qR configuration in aVL, with a QRS duration less than 120 ms. Non-specific IVCD was defined as QRS duration ≥ 120 ms not meeting RBBB or LBBB criteria ( Fig. LBBB was defined by the Strauss definition. Four of the conduction delays were classified according to the respective Minnesota classes: RBBB (code 7–2), incomplete RBBB (iRBBB) (code 7–3), the R-R’ pattern in either of leads V1 and V2 with R’ amplitude ≤ R (R-R′ pattern) (code 7–5), and incomplete LBBB (iLBBB) (code 7–6).
#Ivcd with lbbb software#
The main exposure variables were IVCDs - for their identification, both Minnesota codes and measurements based on the Magellan software program were used. The participants in the survey signed an informed consent both before the health interview and at the beginning of the health examination. The study protocol of the Health 2000 Survey was approved by the Epidemiology Ethics Committee of the Helsinki and Uusimaa Hospital District. Thus, the analysis was performed with 6080 subjects: 3298 women and 2 782 men (mean age 52.1, SD 14.5 years). We excluded subjects with prevalent HF and SHD from the study ( Fig. The National Care Register for Health Care and the national register on rights to reimbursements for medication costs were linked to the Health 2000 Survey data. blood pressure, resting electrocardiogram (ECG)) and physician’s physical examination was performed. After a home interview a comprehensive health examination including questionnaires, measurements (e.g.
#Ivcd with lbbb professional#
The health examination was performed on each participant 1–6 weeks later at a local health center by centrally trained professional doctors and nurses. The Health 2000 sample comprised 8 028 individuals (3 637 men and 4 391 women) aged 30 or older, of whom 79% (6 354 individuals 2 876 men and 3 478 women) participated in the health examination. The implementation of the survey is described in detail elsewhere. For the population aged ≥ 80 years, the sampling probability was twice as high as among those <80 years. The sampling included both largest cities and smaller regions and suburbs. In brief, a representative stratified random cluster sample of the Finnish population was examined. The purpose of the survey was to provide an up-to-date epidemiological data of major public health problems in Finland, their causes and treatment. The survey was carried out in 2000–2001, and a representative stratified random cluster sample of the Finnish population was examined. The Health 2000 is a major Finnish health examination survey. The aim of this study was to explore the association between IVCDs and new-onset HF and SHD in an unbiased random sample of predominantly Caucasian general population during 16.5 years of total follow-up.
Study data regarding the prognostic implications of fascicular blocks, incomplete bundle branch blocks and the R-R’ pattern in either of the leads V1 or V2 to predict HF is practically non-existent. Non-specific IVCD has previously been associated with cardiovascular (CV) mortality and sudden cardiac death, , but the progression to HF has not been extensively studied in patients without overt cardiac disease. Studies conducted in recent years have evaluated the role of LBBB in inducing left ventricular systolic decline, , while RBBB should play no significant negative role in this aspect. IVCDs are frequent in patients with structural heart disease (SHD), including valvular heart diseases and cardiomyopathies, but no prior prospective population studies have related IVCDs to novel SHD in subjects without known heart disease. Literature assessing the role of IVCDs as risk markers for the development of HF is scarce and has presented conflicting results, and has evaluated only selected bundle branch block categories, ,. For timely initiation of therapy, subjects with high-risk of developing HF ought to be identified. Mortality rates remain high in symptomatic patients with advanced HF and reduced ejection fraction in spite of improvements in medical therapy and effective utilization of cardiac resynchronization therapy. Left bundle branch block (LBBB), right bundle branch block (RBBB), and non-specific IVCD were associated with increased mortality especially in patients with myocardial infarction (MI), , and heart failure (HF),. Intraventricular conduction delays (IVCDs) have been associated with impaired prognosis in patients with known cardiac disease.