Such conduction delays may be due to myocardial fibrosis, amyloidosis, cardiomyopathy or hypertrophy. Some patients develop nonspecific intraventricular conduction defects without any change in their QRS appearance. Description of QRS morphology in this tracing might therefore better be classified as IVCD with LAD (intraventricular conduction delay with left axis. Such conduction disturbances may also be superimposed on existing bundle branch blocks and alter their appearance. The main finding of the present study is that nonspecific intraventricular conduction disturbance (IVCD) in an ECG is associated with increased mortality and a markedly elevated risk of sudden arrhythmic death in a general population. These conduction delays may be observed after large myocardial infarctions, in which the large necrotic area may cause nonspecific conduction disturbances. Definition and causes of nonspecific intraventricular conduction delayĪccording to the American Heart Association/American College of Cardiology and the Heart Rhythm Society (AHA/ACCF/HRS) recommendations (2009), nonspecific intraventricular conduction delay is defined by “a QRS duration greater than 110 ms in adults, greater than 90 ms in children 8 to 16 years of age, and greater than 80 ms in children less than 8 years of age without meeting the criteria for RBBB or LBBB." Thus, the appearance of nonspecific intraventricular conduction delay may be rather nuanced. Nonspecific intraventricular conduction delay exists if the ECG displays a widened QRS appearance that is neither a left bundle branch block (LBBB) nor a right bundle branch block (RBBB). Nonspecific intraventricular conduction delay
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