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Association of Newly Developed Right Bundle Branch Block with Graft Rejection Following Heart Transplantation

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Affiliated Author(s)
김인철
Alternative Author(s)
Kim, In Cheol
Journal Title
Yonsei Medical Journal
ISSN
1976-2437
Issued Date
2019
Keyword
Right bundle branch blockheart transplantationrejection
Abstract
Purpose:
We aimed to examine associations between right bundle branch block (RBBB) following heart transplantation (HT) and graft rejection.

Materials and Methods:
We investigated 51 patients who underwent endomyocardial biopsies, electrocardiogram, right-side cardiac catheterization, and echocardiography at 1 month and 1 year after HT. We classified patients into four groups according to the development of RBBB, based on electrocardiogram at 1 month and 1 year: 1) sustained RBBB, 2) disappeared RBBB, 3) newly developed RBBB, and 4) sustained non-RBBB. The RBBB was defined as an RSR' pattern in V1 with a QRS duration ≥100 ms on electrocardiogram.

Results:
The newly developed RBBB group (n=13, 25.5%) had a higher rate of new onset graft rejection (from grade 0 to grade ≥1R, 30.8% vs. 10.0% vs. 21.4%, p=0.042) at 1 year, compared with sustained RBBB (n=10, 19.6%) and sustained non-RBBB group (n=28, 54.9%). In contrast, the incidence of resolved graft rejection (from grade ≥1R to grade 0) was higher in the sustained RBBB group than the newly developed RBBB and sustained non-RBBB groups (70.0% vs. 7.7% vs. 25.0%, p=0.042). Left atrial volume index was significantly higher in the newly developed RBBB group than the sustained RBBB and sustained non-RBBB groups (60.6±25.9 mL/m2 vs. 36.0±11.0 mL/m2 vs. 38.4±18.1 mL/m2, p=0.003).

Conclusion:
Close monitoring for new development of RBBB at 1 year after HT, which was associated with a higher incidence of new onset graft rejection, may be helpful to identify high risk patients for graft rejection.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine (의과대학)
Citation
Jin-Ho Kim et al. (2019). Association of Newly Developed Right Bundle Branch Block with Graft Rejection Following Heart Transplantation. Yonsei Medical Journal, 60(5), 423–428. doi: 10.3349/ymj.2019.60.5.423
Type
Article
ISSN
1976-2437
DOI
10.3349/ymj.2019.60.5.423
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41993
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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