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1. 心室内伝導遅延への基本的アプローチbasic approach to delayed intraventricular conduction [show details]
… left or right bundle morphology, or that have features of both. The term nonspecific IVCD is helpful in designating this category since it implies that the QRS does not show a classic left or right bundle …
2. 心電図チュートリアル：心室内ブロックecg tutorial intraventricular block [show details]
… it is actually an intraventricular conduction delay of the right ventricle,… bundles, or is conducted with diffuse slowing throughout the His Purkinje system, resulting in a nonspecific intraventricular delay. Thus, there is rate-related widening of the QRS complex occurring when…
3. 左脚ブロックleft bundle branch block [show details]
…resynchronization therapy with biventricular pacing in patients with heart failure who have an intraventricular conduction delay, primarily due to LBBB. Exercise-induced LBBB occurs transiently in approximately…
4. QRS幅の広い頻脈：原因、疫学、臨床症状wide qrs complex tachycardias causes epidemiology and clinical manifestations [show details]
…patients with a left bundle branch block (LBBB), right bundle branch block, or a nonspecific intraventricular conduction delay on their baseline ECG, any SVT will have a widened QRS. Thus, if time allows,…
5. 心電図チュートリアル：SＴ波およびT波の変化ecg tutorial st and t wave changes [show details]
… Nonspecific ST-T wave changes are very common and may be seen in any lead of the electrocardiogram.… Intraventricular conduction delays: ST-T wave abnormalities secondary to intraventricular…

English Journal

On-treatment comparison between corrective his bundle pacing and biventricular pacing for cardiac resynchronization: A secondary analysis of his-sync.

Upadhyay GA, Vijayaraman P, Nayak HM, Verma N, Dandamudi G, Sharma PS, Saleem M, Mandrola J, Genovese D, Oren JW, Subzposh FA, Aziz Z, Beaser A, Shatz D, Besser S, Lang RM, Trohman RG, Knight BP, Tung R, .
Heart rhythm. 2019 May;().
The His-SYNC pilot trial was the first randomized comparison between His bundle pacing in lieu of an LV lead for cardiac resynchronization therapy (His-CRT) and biventricular pacing (BiV-CRT), but was limited by high rates of crossover. To evaluate the results of the HIS SYNC pilot trial utilizing t
PMID 31096064

Prognostic Implication of Ventricular Conduction Disturbance Pattern in Hospitalized Patients with Acute Heart Failure Syndrome.

Lee JH, Park JJ, Cho Y, Oh IY, Yoo BS, Kim JJ, Kim KH, Kang SM, Baek SH, Jeon ES, Cho MC, Chae SC, Oh BH, Choi DJ.
Korean circulation journal. 2019 Feb;().
Conflicting data exist regarding the prognostic implication of ventricular conduction disturbance pattern in patients with heart failure (HF). This study investigated the prognostic impact of ventricular conduction pattern in hospitalized patients with acute HF. Data from the Korean Acute Heart Fail
PMID 30891964

Novel approach to discriminate left bundle branch block from nonspecific intraventricular conduction delay using pacing-induced functional left bundle branch block.

Scholz EP, Fischer P, Lugenbiel P, Xynogalos P, Schweizer PA, Scherer D, Thomas D, Katus HA, Zitron E.
Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing. 2018 Dec;53(3)347-355.
Left bundle branch block (LBBB) has a predictive value for response to cardiac resynchronization therapy as reported by Zareba et al. (Circulation 123(10):1061-1072, 2011). However, based on ECG criteria, the discrimination between complete LBBB and nonspecific intraventricular conduction delay is c
PMID 30232686

Japanese Journal

Effects of Cardiac Resynchronization Therapy on Ventricular Electrical Remodeling in Patients With Heart Failure

Zhang Jianghua,Xing Qiang,Zhou Xianhui,Zhang Yu,Li Yaodong,Li Jinxin,Tang Baopeng
International Heart Journal 56(5), 495-499, 2015
… Larger numbers of non-responders were diagnosed with either ischemic cardiomyopathy (ICM) or nonspecific intraventricular conduction delay (NICD). … 0.05), while there was no significant change in intrinsic QRS duration.<br>While CRT does not reduce the intrinsic QRS duration, it can delay negative ventricular electrical remodeling. …
NAID 130005102119

「非特異的心室内伝導遅延」

　　[★]

英: nonspecific intraventricular conduction delay
関: QRS間隔

定義

脚ブロックのように特定の伝導路で伝導が遅くなっているのではなく、すべての誘導で伝導が遅延している物。
QRS間隔は 0.10～0.11程度のものを指すようだ。

ドクターサロン59巻５月号（4.2015）321）1

QRSが0.11秒以上で、左脚ブロック、右脚ブロックというカテゴリーの基準に該当しないもの。QRS間隔は0.11秒以上、0.12秒未満のもの。

病態生理

はっきりしない。薬剤性という説がかつてあったらしい。スポーツをするアスリートの場合、スポーツ心、つまり心肥大により伝導路が長くなり伝導が遅延しているというのが1つの説明とされている。

健診

健診でしばしば自動解析結果に表示されるが、病的意義は洞性不整脈と同様にほぼない。心血管リスクやそのほかの併存症・既往歴がなければ、毎年の健診でフォローアップするのみで良いと考えている。

とはいえ、突然死のリスクになり得るなどという報告がある。ただし、研究は60-70歳程度の集団を対象としているので、20-50歳代の方には当てはまらない！！

Abstract 13286: Non-Specific Intraventricular Conduction Delay and Risk of Sudden Death
https://www.ahajournals.org/doi/abs/10.1161/circ.130.suppl_2.13286