OBJECTIVES: Risk stratification in acute congestive heart failure (ACHF) is poorly defined. The aim of the present study was to assess the impact of right bundle brunch block (RBBB) on long-term mortality in patients presenting with ACHF. METHODS AND RESULTS: The initial 12-lead electrocardiogram was analysed for RBBB in 192 consecutive patients presenting with ACHF to the emergency department. The primary endpoint was all-cause mortality during 720-day follow-up. This study included an elderly cohort (mean age 74 years) of ACHF patients. RBBB was present in 27 patients (14%). Age, sex, B-type natriuretic peptide levels and initial management were similar in patients with RBBB when compared with patients without RBBB. However, patients with RBBB more often had pulmonary comorbidity. A total of 84 patients died during follow-up. Kaplan-Meier analysis revealed that mortality at 720 days was significantly higher in patients with RBBB when compared with patients without RBBB (63% vs. 39%, P = 0.004). In Cox proportional hazard analysis, RBBB was associated with a two-fold increase in mortality (hazard ratio 2.18, 95% CI 1.26-3.66; P = 0.003). This association persisted after adjustment for age and comorbidity. CONCLUSIONS: RBBB is a powerful predictor of mortality in patients with ACHF. Early identification of this high-risk group may help to offer tailored treatment in order to improve outcome.
OBJECTIVES: Risk stratification in acute congestive heart failure (ACHF) is poorly defined. The aim of the present study was to assess the impact of right bundle brunch block (RBBB) on long-term mortality in patients presenting with ACHF. METHODS AND RESULTS: The initial 12-lead electrocardiogram was analysed for RBBB in 192 consecutive patients presenting with ACHF to the emergency department. The primary endpoint was all-cause mortality during 720-day follow-up. This study included an elderly cohort (mean age 74 years) of ACHF patients. RBBB was present in 27 patients (14%). Age, sex, B-type natriuretic peptide levels and initial management were similar in patients with RBBB when compared with patients without RBBB. However, patients with RBBB more often had pulmonary comorbidity. A total of 84 patients died during follow-up. Kaplan-Meier analysis revealed that mortality at 720 days was significantly higher in patients with RBBB when compared with patients without RBBB (63% vs. 39%, P = 0.004). In Cox proportional hazard analysis, RBBB was associated with a two-fold increase in mortality (hazard ratio 2.18, 95% CI 1.26-3.66; P = 0.003). This association persisted after adjustment for age and comorbidity. CONCLUSIONS: RBBB is a powerful predictor of mortality in patients with ACHF. Early identification of this high-risk group may help to offer tailored treatment in order to improve outcome.
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: Heli Tolppanen; Krista Siirila-Waris; Veli-Pekka Harjola; David Marono; Jiri Parenica; Philipp Kreutzinger; Tuomo Nieminen; Marie Pavlusova; Tuukka Tarvasmaki; Raphael Twerenbold; Jukka Tolonen; Roman Miklik; Markku S Nieminen; Jindrich Spinar; Christian Mueller; Johan Lassus Journal: ESC Heart Fail Date: 2015-10-30
Authors: M Alventosa-Zaidin; G Pera; C Roca Saumell; N Mengual Miralles; M V Zamora Sanchez; T Gros Garcia; L Guix Font; M Benitez Camps; J Francisco-Pascual; J Brugada Terradellas Journal: BMC Fam Pract Date: 2019-05-06 Impact factor: 2.497