PMID: 9440667Jan 24, 1998Paper

Prognostic significance of exercise-induced left bundle-branch block

JAMA : the Journal of the American Medical Association
T A GradyM S Lauer

Abstract

Approximately 0.5% of all patients who undergo exercise testing develop a transient left bundle-branch block (LBBB) during exercise, but its prognostic significance is unclear. To determine whether exercise-induced LBBB is an independent predictor of mortality and cardiac morbidity. Matched control cohort study. Between September 1990 and February 10, 1994, 17277 exercise stress tests were performed on patients. Tertiary care, academic medical center. From the cohort, 70 cases of exercise-induced LBBB were identified. The controls comprised 70 individuals without LBBB at rest or during exercise that matched the 70 cases based on age, test date, sex, prior history of coronary artery disease, hypertension, diabetes, smoking, and beta-blocker use. All-cause mortality, percutaneous coronary intervention, open heart surgery, nonfatal myocardial infarction, documented symptomatic or sustained ventricular tachydysrhythmia, or implantation of a permanent pacemaker or an implantable cardiac defibrillator. A total of 37 events (28 events from the exercise-induced LBBB cases and 9 from the control cohort) occurred in 25 patients (17 exercise-induced LBBB patients and 8 control patients) during a mean follow-up period of 3.7 (0.9 years) (m...Continue Reading

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