Reservations about the Selvester QRS score in left bundle branch block - Experience in patients with transcatheter aortic valve implantation

Thomas T. Poels, Suzanne Kats, Leo Veenstra, Vincent van Ommen, Jos G. Maessen, Frits W. Prinzen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Background: The Selvester QRS score (S-score) estimates myocardial scar using electrocardio-graphic criteria. We evaluated the S-score for left bundle branch block (LBBB).

Material and methods: Studied were 36 patients who developed persistent LBBB upon transcatheter aortic valve implantation (TAVI, TAVI-LBBB group) and 36 matched patients with persistent narrow QRS (TAVI-nQRS group). Electrocardiograms were recorded before and briefly after TAVI and during similar to 6 months follow-up. S-score was calculated using criteria for hypertrophic (in absence of LBBB) or LBBB hearts.

Results: In TAVI-LBBB patients correlation between S-scores pre-TAVI and post-TAVI was absent (R-2 = 0.023). High S-scores post-TAVI occurred in patients with low pre-TAVI scores. Pre-post TAVI scores correlated weakly in TAVI-nQRS (R-2 = 0.182), indicating a possible influence of ventricular unloading by TAVI. In both groups S-scores at post-TAVI and follow-up compared reasonably (R-2 = 0.389 and R-2 = 0.386), indicating reproducibility in more stable conditions.

Conclusion: This study indicates that the use of the LBBB S-score criteria overestimates scar size and that caution is recommended in the use of the score in patients with LBBB. (C) 2017 The Author(s). Published by Elsevier Inc.

Original languageEnglish
Pages (from-to)261-267
Number of pages7
JournalJournal of Electrocardiology
Volume50
Issue number2
DOIs
Publication statusPublished - 2017

Keywords

  • Transcatheter aortic valve implantation
  • Left bundle branch block
  • Selvester QRS scoring
  • Myocardial scar
  • Electrocardiography
  • MYOCARDIAL INFARCT SIZE
  • CARDIAC RESYNCHRONIZATION THERAPY
  • QUANTITATIVE ANATOMIC FINDINGS
  • CONDUCTION ABNORMALITIES
  • SCAR
  • SYSTEM
  • QUANTIFICATION
  • SPECIFICITY

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