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. 2012 Dec;3(6):258-263.
doi: 10.4021/cr214w. Epub 2012 Nov 20.

Asymptomatic Left Bundle Branch Block Predicts New-Onset Congestive Heart Failure and Death From Cardiovascular Diseases

Peyman N Azadani  1 , Ata Soleimanirahbar  2 , Gregory M Marcus  2 , Thaddeus J Haight  3 , Milton Hollenberg  2 , Jeffrey E Olgin  2 , Byron K Lee  2
Affiliations

Asymptomatic Left Bundle Branch Block Predicts New-Onset Congestive Heart Failure and Death From Cardiovascular Diseases

Peyman N Azadani et al. Cardiol Res. 2012 Dec.

Abstract

Background: Left bundle branch block (LBBB) has been proposed as a risk factor for cardiovascular morbidity and mortality. We sought to characterize the strength of these associations in a population without preexisting clinical heart disease.

Methods: The association between LBBB and new-onset congestive heart failure (CHF) or death from cardiovascular diseases was examined in 1,688 participants enrolled in the SPPARCS study who were free of known CHF or previous myocardial infarction. SPPARCS is a community-based cohort study in residents of Sonoma, California that are > 55 years. Medical history and 12-lead ECGs were obtained every 2 years for up to 6 years of follow-up. LBBB at enrollment or year 2 was considered "baseline" and assessed as a predictor of CHF and cardiovascular death ascertained at years 4 and 6.

Results: The prevalence of LBBB at baseline was 2.5% (n = 42). During 6 years of follow-up, 70 (4.8%) people developed new CHF. Incidence of CHF was higher in patients with LBBB than in participants without LBBB. This association persisted after controlling for potential confounders (odds ratio (OR): 2.85; 95% confidence interval (CI): 1.01 - 8.02; P = 0.047). A higher mortality from cardiovascular diseases was also found in participants with LBBB after adjusting for potential confounders (OR: 2.35, 95%CI: 1.02 - 5.41; P = 0.044).

Conclusions: LBBB in the absence of a clinically detectable heart disease is associated with new-onset CHF and death from cardiovascular diseases. Further study is warranted to determine if additional diagnostic testing or earlier treatment in patients with asymptomatic LBBB can decrease cardiovascular morbidity or mortality.

Keywords: Bundle-branch block; Heart failure; Mortality; Risk factors.

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Figures

Figure 1
Figure 1
Age distribution of LBBB at baseline.
Figure 2
Figure 2
Kaplan-Meier survival curve showing the effects of left bundle branch block on cardiovascular mortality by age (P < 0.05).
See this image and copyright information in PMC

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References

    1. Hardarson T, Arnason A, Eliasson GJ, Palsson K, Eyjolfsson K, Sigfusson N. Left bundle branch block: prevalence, incidence, follow-up and outcome. Eur Heart J. 1987;8(10):1075–1079. - PubMed
    1. Fahy GJ, Pinski SL, Miller DP, McCabe N, Pye C, Walsh MJ, Robinson K. Natural history of isolated bundle branch block. Am J Cardiol. 1996;77(14):1185–1190. doi: 10.1016/S0002-9149(96)00160-9. - DOI - PubMed
    1. Freedman RA, Alderman EL, Sheffield LT, Saporito M, Fisher LD. Bundle branch block in patients with chronic coronary artery disease: angiographic correlates and prognostic significance. J Am Coll Cardiol. 1987;10(1):73–80. doi: 10.1016/S0735-1097(87)80162-6. - DOI - PubMed
    1. Wong CK, Stewart RA, Gao W, French JK, Raffel C, White HD. Prognostic differences between different types of bundle branch block during the early phase of acute myocardial infarction: insights from the Hirulog and Early Reperfusion or Occlusion (HERO)-2 trial. Eur Heart J. 2006;27(1):21–28. doi: 10.1093/eurheartj/ehi622. - DOI - PubMed
    1. Guerrero M, Harjai K, Stone GW, Brodie B, Cox D, Boura J, Grines L. et al. Comparison of the prognostic effect of left versus right versus no bundle branch block on presenting electrocardiogram in acute myocardial infarction patients treated with primary angioplasty in the primary angioplasty in myocardial infarction trials. Am J Cardiol. 2005;96(4):482–488. doi: 10.1016/j.amjcard.2005.04.006. - DOI - PubMed