BACKGROUND: The determinants of bundle block patterns and their relationship to mortality in heart failure patients is not completely understood. METHODS: We evaluated 2907 consecutive patients admitted to an intensive care unit with decompensated heart failure over 8 years. Clinical and echocardiographic factors were analyzed using multivariate techniques. All-cause mortality was available on greater than 99.0% of patients at a median of 23 months after discharge. RESULTS: Right and left bundle branch blocks occurred in 211 (7.3%) and 386 (13.2%), p<0.0001. Older age, decreased left ventricular ejection fraction, and renal dysfunction were all found to be independently associated with bundle branch block patterns. Mortality rates for the subgroups of QRS<120 ms, right bundle branch block and left bundle branch block, over a mean follow-up of 23.4+/-2.6 months were 46.1%, 56.8% and 57.7%, p<0.0001 for comparison of QRS<120 ms versus either bundle pattern. Cox proportional hazards model adjusting for age, sex, ejection fraction, and renal function demonstrated graded decrements in survival in those with QRS<120 ms, right bundle branch block and left bundle branch block, p=0.03. CONCLUSIONS: In patients hospitalized with severe heart failure, age, left ventricular dysfunction, and renal dysfunction are associated with bundle branch block patterns. When controlling for these factors, bundle branch block patterns are independently associated with slightly higher all cause mortality after discharge.
BACKGROUND: The determinants of bundle block patterns and their relationship to mortality in heart failurepatients is not completely understood. METHODS: We evaluated 2907 consecutive patients admitted to an intensive care unit with decompensated heart failure over 8 years. Clinical and echocardiographic factors were analyzed using multivariate techniques. All-cause mortality was available on greater than 99.0% of patients at a median of 23 months after discharge. RESULTS: Right and left bundle branch blocks occurred in 211 (7.3%) and 386 (13.2%), p<0.0001. Older age, decreased left ventricular ejection fraction, and renal dysfunction were all found to be independently associated with bundle branch block patterns. Mortality rates for the subgroups of QRS<120 ms, right bundle branch block and left bundle branch block, over a mean follow-up of 23.4+/-2.6 months were 46.1%, 56.8% and 57.7%, p<0.0001 for comparison of QRS<120 ms versus either bundle pattern. Cox proportional hazards model adjusting for age, sex, ejection fraction, and renal function demonstrated graded decrements in survival in those with QRS<120 ms, right bundle branch block and left bundle branch block, p=0.03. CONCLUSIONS: In patients hospitalized with severe heart failure, age, left ventricular dysfunction, and renal dysfunction are associated with bundle branch block patterns. When controlling for these factors, bundle branch block patterns are independently associated with slightly higher all cause mortality after discharge.
Authors: Jan Václavík; Jindřich Špinar; David Vindiš; Jiří Vítovec; Petr Widimský; Čestmír Číhalík; Aleš Linhart; Filip Málek; Miloš Táborský; Ladislav Dušek; Jiří Jarkovský; Marián Fedorco; Marián Felšöci; Roman Miklík; Jiří Pařenica Journal: Intern Emerg Med Date: 2012-10-06 Impact factor: 3.397
Authors: N Bouqata; J Kheyi; F Miftah; H Sabor; A Bouziane; H Bouzelmat; A Chaib; A Benyass; A Moustaghfir Journal: J Saudi Heart Assoc Date: 2014-08-28
Authors: Juan Cinca; Ana Mendez; Teresa Puig; Andreu Ferrero; Eulalia Roig; Rafael Vazquez; Jose R Gonzalez-Juanatey; Luis Alonso-Pulpon; Juan Delgado; Josep Brugada; Domingo Pascual-Figal Journal: Eur J Heart Fail Date: 2013-03-19 Impact factor: 15.534