| Prevalence and prognostic significance of exercise-induced right bundle branch block. | |
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MedLine Citation:
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PMID: 20185016 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Exercise-induced (EI) right bundle branch block (RBBB) is an infrequent electrocardiographic phenomenon, and controversy exists regarding its association with cardiovascular disease. We compared the prevalence and prognostic significance of RBBB, abnormal ST depression, and normal electrocardiographic findings in response to exercise testing in 9,623 consecutive veterans who underwent exercise testing from 1987 to 2007. EI RBBB, EI ST depression, and a normal exercise electrocardiographic response occurred in 0.24%, 15.2%, and 71.9% veterans, respectively. After appropriate exclusions, of the 8,047 patients analyzed, 6 patients in the EI RBBB subgroup died. Of these 6 deaths, 3 were cardiovascular deaths during the 9 years of follow-up. The annual death rate was 7.3% (1.4% cardiac deaths), 2.6% (1.2% cardiac deaths), and 1.8% (0.6% cardiac death) among those with EI RBBB, EI ST depression, and a normal ST response, respectively (p <0.0001). The patients with EI RBBB were significantly older, more overweight, and had a greater prevalence of coronary artery disease, heart failure, and hypertension compared to the 2 other subgroups. Patients with EI RBBB had an age-adjusted Cox proportional hazard ratio of 1.13 (p = 0.75, 95% confidence interval 0.51 to 2.5) for all-cause mortality and 1.57 (p = 0.43, 95% confidence interval 0.51 to 4.8) for cardiovascular mortality, respectively. In conclusion, EI RBBB is a rare occurrence during routine clinical exercise testing that appears to be benign. |
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Authors:
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Ricardo Stein; Patricia Nguyen; Joshua Abella; Harold Olson; Jonathan Myers; Victor Froelicher |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 105 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-02-26 Completed Date: 2010-04-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 677-80 Citation Subset: AIM; IM |
Copyright Information:
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Published by Elsevier Inc. |
Affiliation:
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Exercise Pathophysiology Research Laboratory, Cardiology Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bundle-Branch Block / diagnosis*, epidemiology*, physiopathology Case-Control Studies Cohort Studies Electrocardiography Exercise* Exercise Test Female Humans Male Middle Aged Prevalence Prognosis Risk Factors Survival Analysis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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