Effect of bundle branch block patterns on mortality in hospitalized patients with heart failure

The American Journal of Cardiology
Alon BarsheshetMichael Glikson

Abstract

A widened QRS interval is associated with increased mortality in patients with heart failure (HF). However, the prognostic significance of the type of bundle branch block (BBB) pattern in these patients is unclear. The data of 4,102 patients with HF hospitalized during a prospective national survey were analyzed to investigate the association between BBB type and 1-year mortality in 3,737 patients without pacemakers. Right BBB (RBBB) was present in 381 patients (10.2%) and left BBB (LBBB) in 504 patients (13.5%). RBBB and LBBB were associated with increased 1-year mortality on univariate analysis (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.15 to 1.81, and OR 1.20, 95% CI 0.97 to 1.47, respectively). In patients with systolic HF, after adjusting for multiple risk factors, only RBBB was found to be an independent predictor of mortality (RBBB vs no BBB OR 1.62, 95% CI 1.12 to 2.33, and RBBB vs LBBB OR 1.71, 95% CI 1.09 to 2.69). This correlation was stronger in patients with lower left ventricular ejection fractions and was also maintained in patients without acute myocardial infarctions. Analyzing the data for all patients with HF, there was a trend for increased mortality in the RBBB group only (adjusted OR 1.21, 95% C...Continue Reading

References

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Citations

Dec 28, 2010·The American Journal of Cardiology·Alon BarsheshetMichael Glikson
May 3, 2011·Heart Failure Reviews·Luigi PadelettiEdoardo Gronda
Mar 29, 2011·The American Journal of Cardiology·Sameer BansilalMichael E Farkouh
Mar 6, 2010·International Journal of Cardiology·Husam M Abdel-QadirDouglas S Lee
Sep 1, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Anita WokhluYong-Mei Cha
Aug 6, 2008·The American Journal of Cardiology·J Willis Hurst
Jul 17, 2012·International Journal of Cardiology·Karen SliwaSimon Stewart
Feb 15, 2012·Nature Reviews. Cardiology·Alon BarsheshetArthur J Moss

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