The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance.

Journal Article (Journal Article)

AIMS: We aimed to improve the electrocardiographic 2009 left bundle branch block (LBBB) Selvester QRS score (2009 LBSS) for scar assessment. METHODS: We retrospectively identified 325 LBBB patients with available ECG and cardiovascular magnetic resonance imaging (CMR) with late gadolinium enhancement from four centers (142 [44%] with CMR scar). Forty-four semi-automatically measured ECG variables pre-selected based on the 2009 LBSS yielded one multivariable model for scar detection and another for scar quantification. RESULTS: The 2009 LBSS achieved an area under the curve (AUC) of 0.60 (95% confidence interval 0.54-0.66) for scar detection, and R2 = 0.04, p < 0.001, for scar quantification. Multivariable modeling improved scar detection to AUC 0.72 (0.66-0.77) and scar quantification to R2 = 0.21, p < 0.001. CONCLUSIONS: The 2009 LBSS detects and quantifies myocardial scar with poor accuracy. Improved models with extensive comparison of ECG and CMR had modest performance, indicating limited room for improvement of the 2009 LBSS.

Full Text

Duke Authors

Cited Authors

  • Wieslander, B; Xia, X; Jablonowski, R; Axelsson, J; Klem, I; Nijveldt, R; Maynard, C; Schelbert, EB; Sörensson, P; Sigfridsson, A; Chaudhry, U; Platonov, PG; Borgquist, R; Engblom, H; Couderc, J-P; Strauss, DG; Atwater, BD; Ugander, M

Published Date

  • 2018

Published In

Volume / Issue

  • 51 / 5

Start / End Page

  • 779 - 786

PubMed ID

  • 30177312

Electronic International Standard Serial Number (EISSN)

  • 1532-8430

Digital Object Identifier (DOI)

  • 10.1016/j.jelectrocard.2018.05.019


  • eng

Conference Location

  • United States