Nonspecific intraventricular conduction delay: Definitions, prognosis, and implications for cardiac resynchronization therapy. Circ Arrhythm Electrophysiol 2011 4:704–710. Intraventricular conduction delay in a standard 12-lead electrocardiogram as a predictor of mortality in the general population. Aro AL, Anttonen O, Tikkanen JT, et al.For example, Wolff-Parkinson-White syndrome (WPW), pacemaker-stimulated beats, electrolyte imbalance and medications may prolong the QRS complex. For inpatient stays, unconfirmed diagnoses are indicated using phrases like. In the inpatient setting, there are two categories of diagnoses: confirmed diagnoses and unconfirmed diagnoses. Note that other causes of wide QRS complex must always be considered. A borderline ECG normal sinus rhythm could mean that the results are within normal ranges but on the verge of being abnormal. Individuals with nonspecific intraventricular conduction delays were at particularly high risk of death due to arrhythmias. This was reported in the Coronary Heart Disease Study,1 which enrolled 10,899 participants with baseline ECG examinations. Patients with nonspecific intraventricular conduction delays are at twice as great a risk of all-cause death and cardiovascular death, compared to patients without such disturbances, including those with RBBB and LBBB. Prognosis of nonspecific intraventricular conduction delay Individuals with IVCD had a higher prevalence of heart failure, CHD, and MI, and a higher rate of all-cause and CV mortality than those without conduction delay. Such conduction delays may be due to myocardial fibrosis, amyloidosis, cardiomyopathy or hypertrophy. Some patients develop nonspecific intraventricular conduction defects without any change in their QRS appearance. Created for people with ongoing healthcare needs but benefits everyone. Such conduction disturbances may also be superimposed on existing bundle branch blocks and alter their appearance. Likely normal: Sinus arrhythmia (irregular length between beats) is a normal finding.It is often exaggerated by taking a deep breath and exhaling. These conduction delays may be observed after large myocardial infarctions, in which the large necrotic area may cause nonspecific conduction disturbances. Definition and causes of nonspecific intraventricular conduction delayĪccording to the American Heart Association/American College of Cardiology and the Heart Rhythm Society (AHA/ACCF/HRS) recommendations, a nonspecific intraventricular conduction delay is defined as “a QRS duration greater than 110 ms in adults, greater than 90 ms in children 8 to 16 years of age, and greater than 80 ms in children less than 8 years of age without meeting the criteria for RBBB or LBBB.” The QRS morphology of nonspecific intraventricular conduction delays may vary substantially. Nonspecific intraventricular conduction delayĪ nonspecific intraventricular conduction delay exists if the ECG displays a widened QRS appearance that is neither a left bundle branch block (LBBB) nor a right bundle branch block (RBBB).
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