Jiménez-Blanco Bravo, MartaAlonso Salinas, Gonzalo LuisParra Esteban, CarolinaToquero Ramos, JorgeAmores Luque, MiguelZamorano Gómez, José LuisGarcía-Izquierdo, EusebioÁlvarez-García, JesúsFernández Lozano, IgnacioCastro Urda, Víctor2024-10-242024-10-242024-06-01Jiménez-Blanco Bravo, M., Alonso Salinas, G. L., Parra Esteban, C., Toquero Ramos, J., Amores Luque, M., Zamorano Gómez, J. L., García-Izquierdo, E., Álvarez-García, J., Fernández Lozano, I., Castro Urda, V. (2024) Right bundle branch block predicts appropriate implantable cardioverter defibrillator therapies in patients with non-Iischemic dilated cardiomyopathy and a prophylactic implantable cardioverter defibrillator. Diagnostics, 14(11), 1-10. https://doi.org/10.3390/diagnostics14111173.2075-441810.3390/diagnostics14111173https://academica-e.unavarra.es/handle/2454/52374Background: the benefit of prophylactic implantable cardioverter defibrillators (ICDs) in patients with severe systolic dysfunction of non-ischemic origin is still unclear, and the identification of patients at risk for sudden cardiac death remains a major challenge. Aims/Methods: we retrospectively reviewed all consecutive patients with non-ischemic dilated cardiomyopathy (NICM) who underwent prophylactic ICD implantation between 2008 and 2020 in two tertiary centers. Our main goal was to identify the predictors of appropriate ICD therapies (anti-tachycardia pacing [ATP] and/or shocks) in this cohort of patients. Results: a total of 224 patients were included. After a median follow-up of 51 months, 61 patients (27.2%) required appropriate ICD therapies. Patients with appropriate ICD therapies were more frequently men (87% vs. 69%, p = 0.006), of younger age (59 years, (53-65) vs. 64 years, (57-70); p = 0.02), showed more right bundle branch blocks (RBBBs) (15% vs. 4%, p = 0.007) and less left bundle branch blocks (LBBBs) (26% vs. 47%, p = 0.005) in the ECG, and had higher left ventricular end-diastolic (100 mL/m2, (90-117) vs. 86, (71-110); p = 0.011) and systolic volumes (72 mL/m2, (59-87) vs. 61, (47-81), p = 0.05). In a multivariate competing-risks regression analysis, RBBB (HR 2.26, CI 95% 1.02-4.98, p = 0.043) was identified as an independent predictor of appropriate ICD therapies. Conclusion: RBBBs may help to identify patients with NICM at high risk of ventricular arrhythmias and requiring ICD intervention.application/pdfeng© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.Implantable cardioverter defibrillatorNon-ischemic dilated cardiomyopathyPrimary preventionRight bundle branch blockSudden cardiac deathinfo:eu-repo/semantics/article2024-10-24info:eu-repo/semantics/openAccess