Association Between Right Bundle Branch Block and Ventricular Arrhythmia in Patients With Cardiac Sarcoidosis

Yu Yamada, MD; Kimi Sato, MD, PhD; Masayoshi Yamamoto, MD, PhD; Takeru Nabeta, MD, PhD; Yoshihisa Naruse, MD, PhD; Tatsunori Taniguchi, MD, PhD; Takeshi Kitai, MD, PhD; Kenji Yoshioka, MD, PhD; Hidekazu Tanaka, MD, PhD; Takahiro Okumura, MD, PhD; Yuichi Baba, MD, PhD; Yudai Fujimoto, MD; Yuya Matsue, MD, PhD; Yuki Komatsu, MD, PhD; Akihiko Nogami, MD, PhD; Tomoko Ishizu, MD, PhD

JACC: Advances (Aug 2024)

Association Between Right Bundle Branch Block and Ventricular Arrhythmia in Patients With Cardiac Sarcoidosis

Yu Yamada, MD,
Kimi Sato, MD, PhD,
Masayoshi Yamamoto, MD, PhD,
Takeru Nabeta, MD, PhD,
Yoshihisa Naruse, MD, PhD,
Tatsunori Taniguchi, MD, PhD,
Takeshi Kitai, MD, PhD,
Kenji Yoshioka, MD, PhD,
Hidekazu Tanaka, MD, PhD,
Takahiro Okumura, MD, PhD,
Yuichi Baba, MD, PhD,
Yudai Fujimoto, MD,
Yuya Matsue, MD, PhD,
Yuki Komatsu, MD, PhD,
Akihiko Nogami, MD, PhD,
Tomoko Ishizu, MD, PhD

Affiliations

Yu Yamada, MD: Department of Cardiology, Institute of Medicine; University of Tsukuba, Tsukuba, Japan
Kimi Sato, MD, PhD: Department of Cardiology, Institute of Medicine; University of Tsukuba, Tsukuba, Japan; Address for correspondence: Dr Kimi Sato, Department of Cardiology, Institute of Medicine University of Tsukuba 1-1-1 Tennodai, Tsukuba 3058575, Japan.
Masayoshi Yamamoto, MD, PhD: Department of Cardiology, Institute of Medicine; University of Tsukuba, Tsukuba, Japan
Takeru Nabeta, MD, PhD: Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
Yoshihisa Naruse, MD, PhD: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan
Tatsunori Taniguchi, MD, PhD: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
Takeshi Kitai, MD, PhD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
Kenji Yoshioka, MD, PhD: Department of Cardiology, Kameda Medical Center, Kamogawa, Japan
Hidekazu Tanaka, MD, PhD: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
Takahiro Okumura, MD, PhD: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
Yuichi Baba, MD, PhD: Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Japan
Yudai Fujimoto, MD: Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Hongo, Japan
Yuya Matsue, MD, PhD: Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Hongo, Japan
Yuki Komatsu, MD, PhD: Department of Cardiology, Institute of Medicine; University of Tsukuba, Tsukuba, Japan
Akihiko Nogami, MD, PhD: Department of Cardiology, Institute of Medicine; University of Tsukuba, Tsukuba, Japan
Tomoko Ishizu, MD, PhD: Department of Cardiology, Institute of Medicine; University of Tsukuba, Tsukuba, Japan

Journal volume & issue: Vol. 3, no. 8
p. 101105

Abstract

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Background: Ventricular arrhythmia (VA) is a life-threatening condition associated with cardiac sarcoidosis (CS). Right bundle branch block (RBBB) is a common conduction disorder in CS; however, its association with VA remains unknown. Objectives: This study aimed to investigate the relationship between RBBB and VA in patients with CS. Methods: This was a post hoc analysis of ILLUMINATE-CS (Illustration of the Management and Prognosis of Japanese Patients with Cardiac Sarcoidosis), a multicenter, retrospective, and observational study that evaluated the clinical characteristics and prognosis of CS. Eligible patients were divided into two groups based on the presence or absence of RBBB at the time of diagnosis. The primary outcome was serious ventricular arrhythmia events (SVAEs), defined as a combination of sudden cardiac death and documented ventricular fibrillation, sustained ventricular tachycardia, or appropriate implantable cardioverter-defibrillator therapy. Results: Overall, 312 patients were studied, with 155 (49.7%) patients presenting with RBBB (RBBB group). Patients in the RBBB group had a higher prevalence of basal interventricular septum (IVS) thinning and prominent late gadolinium enhancement in the basal IVS on cardiac magnetic resonance imaging than those in the non-RBBB group. During a median follow-up of 3.0 years (IQR: 1.6-6.0 years), 66 patients experienced SVAE. In multivariable Cox regression analysis, the RBBB group was independently associated with a higher incidence of SVAEs (HR: 1.93 [95% CI: 1.14-3.28]; P = 0.015). Conclusions: In patients with CS, RBBB was an independent predictor of SVAEs, which might reflect the specific scar distribution that is predominant in the IVS.

Published in JACC: Advances

ISSN: 2772-963X (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system; Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid
Website: https://www.sciencedirect.com/journal/jacc-advances

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