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Significance of electrocardiographic right bundle branch block in trained athletes.

Abstract

We sought to determine the clinical and physiologic significance of electrocardiographic complete right bundle branch block (CRBBB) and incomplete right bundle branch block (IRBBB) in trained athletes. The 12-lead electrocardiographic and echocardiographic data from 510 competitive athletes were analyzed. Compared to the 51 age-, sport type-, and gender-matched athletes with normal 12-lead electrocardiographic QRS complex duration, the 44 athletes with IRBBB (9%) and 13 with CRBBB (3%) had larger right ventricular (RV) dimensions, as measured by the basal RV end-diastolic diameter (CRBBB 43 ± 3 mm, IRBBB 38 ± 6 mm, normal QRS complex 35 ± 4 mm, p <0.001) and RV end-diastolic area (CRBBB 33 ± 5, IRBBB 27 ± 7, and normal QRS complex 23 ± 3 cm(2); p <0.001). Athletes with CRBBB also had a relative reduction in the RV systolic function at rest as assessed by the RV fractional area change and peak systolic tissue velocity. Finally, QRS prolongation was associated with parallel increases in interventricular dyssynchrony (basal RV to basal lateral left ventricular peak systolic tissue velocity time difference: CRBBB 112 ± 15, IRBBB 73 ± 33, normal QRS complex 43 ± 39 ms, p <0.001). Despite these findings, no athlete with CRBBB or IRBBB was found to have pathologic structural cardiac disease. In conclusion, among trained athletes, CRBBB and IRBBB appear to be markers of a structural and physiological cardiac remodeling triad characterized by RV dilation, a relative reduction in the RV systolic function at rest, and interventricular dyssynchrony.

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  • Publisher Full Text

    • Authors

    Kim JH, Noseworthy PA, McCarty D, Yared K, Weiner R, Wang F, Wood MJ, Hutter AM, Picard MH, Baggish AL

    Institution

    Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.

    Source

    The American journal of cardiology 107:7 2011 Apr 1 pg 1083-9

    MeSH

    Adolescent
    Athletes
    Atrial Function, Right
    Bundle-Branch Block
    Cardiomegaly
    Cohort Studies
    Echocardiography
    Electrocardiography
    Female
    Heart Atria
    Heart Septum
    Humans
    Male
    Mass Screening
    Reference Values
    Signal Processing, Computer-Assisted
    Systole
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    21296331