Prognostic impact of left bundle-branch block in the early stable phase after acute myocardial infarction

International Journal of Cardiology
Rüdiger DissmannHeinz Völler

Abstract

Diagnostic marker parameters are needed to enable timely identification of high risk patients after acute myocardial infarction (MI). We assessed risk factors for death and sudden death in stable revascularized patients undergoing guideline-based therapy during an in-patient rehabilitation program more than 3 weeks after acute myocardial infarction. During an in-patient rehabilitation program, 939 patients with a recent myocardial infarction were prospectively included. Besides demographic and clinical data, ejection fraction (EF), Holter ECG, standard 12-lead electrocardiogram (ECG) and baseline laboratory values were determined. Patients were followed up for 18 months. Among multiple variables, left bundle-branch block (LBBB) was the most significant parameter affecting the outcome (combination endpoint of death, resuscitation or ventricular tachycardia (VT)), hazard ratio 7.74 (3.2-18.7, P<0.0001). 42% of the 24 patients with LBBB but only 11.5% of the 62 patients with a left ventricular EF </=30% died during follow-up (P<0.001). LBBB observed during a rehabilitation program following an acute MI indicates a grave prognosis with a high mortality rate (mainly caused by sudden death). Future studies are required to establish w...Continue Reading

References

Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
Dec 14, 2004·The New England Journal of Medicine·Stefan H HohnloserUNKNOWN DINAMIT Investigators
Jan 18, 2006·Journal of the American College of Cardiology·Sanjiv M Narayan

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Citations

Dec 3, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Heinz VöllerUNKNOWN PreSCD II registry investigators
Nov 14, 2013·European Heart Journal. Acute Cardiovascular Care·Vasileios LiakopoulosKjeld Christensen

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