Angiographic findings in patients with conduction defect on resting electrocardiography

Abstract

Background: Conduction defect is one of the causes for increase morbidity and mortality among cardiac patients and a predictor of poor prognosis that affect survival and increase mortality rate. Objectives : To study the relationship between angiographic severity and extent of coronary artery in patients with coronary artery disease and conduction defect on resting electrocardiography. Patients and methods : A total of 127 patients participated in this study, (83) males and (44) females of mean age (60.7 ± 10.5 years) presented with chest pain (74%) or shortness of breath (26%) admitted to the coronary care unit at Alsader -teaching hospital and cardiac center at Basrah oil hospital between the period from February 2019-october 2020. Medical history was recorded for comorbidities and cardiovascular risk factors. Electrocardiography was taken for each patient at rest and categorized into LBBB, RBBB, AV Block according to standard ECG criteria. Echocardiography was performed for each patient to assess LV function. All the patients underwent coronary angiography and assessed visually by at least two cardiologists and evaluated using Gensini score calculated for each patient to assess extent and severity of CAD. Results: Patients with conduction defect have a high Gensini score which indicates severe CAD in RBBB more than LBBB patients and significantly higher in three vessels disease, this study showed more extensive CAD and significant correlation among patients with diabetes and hypertension, on other hand; Gensini score was not related to the echocardiographic finding of LV systolic dysfunction. Conclusion: Conduction defect correlates with severe CAD as assessed by coronary angiography especially among hypertensive and diabetic patients.