T-wave Amplitude in aVR for Left Ventricular Dyssynchrony in Patients with Complete Left Bundle Branch Block

Background: Patients with complete left bundle branch block (CLBBB) often had left ventricular (LV) dysfunction including LV dyssynchrony. Conversely, some features of aVR on electrocardiography (ECG) were considered to indicate LV damage. However, the diagnostic performance of aVR for LV dyssynchrony in patients with CLBBB was not elucidated. Methods: We enrolled consecutive 93 patients who underwent ECG and gated semiconductor SPECT simultaneously. LV dyssynchrony was defined as Bandwidth over 143 degree and Phase SD over 45 degree which was reported to predict cardiac-resynchronization-therapy responder. Results: Bandwidth and SD had correlation to T-wave amplitude of aVR. Multivariate analysis showed HR and T-wave amplitude were predictors for LV dyssynchrony (Odds ratio: 1.01, PO.001). ROC curve analysis suggested T-wave amplitude of aVR over -80microV had high diagnostic performance for LV dyssynchrony. Conclusion: T-wave amplitude in aVR was a powerful predictor of LV dyssynchrony in patients with CLBBB.