Document Detail


The prevalence and incidence of left bundle branch block in ambulant patients with chronic heart failure.
MedLine Citation:
PMID:  18501670     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Approximately one third of patients with chronic heart failure have left bundle branch block (LBBB) on their 12-lead ECG.
METHODS AND RESULTS: 1418 consecutive patients (average (SD) age 70.5 (10.4) years; 74% male) first seen in a community heart failure clinic between December 2001 and June 2006 had a 12 lead electrocardiogram (ECG). 485 (34%) had a QRS duration >or=120 ms. Patients with a broad QRS were older (72.2 v 69.3 years), had worse left ventricular systolic function, were on a higher daily dose of diuretic and were more likely to be on amiodarone (14.4 v 7.1%). 12 lead ECG was available for 734 patients (52%) at 1 year follow up. The QRS interval increased from 115.1 ms at baseline to 117.6 (P<0.0001). There were 52 incident cases of LBBB, an incidence of 10.9%. The only predictors of incident LBBB were QRS duration at baseline and amiodarone use at baseline. The proportion of patients with LBBB increased from 34.0% at baseline to 36.7%, 37.7% and 42.3% at 1, 2 and 3 years follow up, respectively. Baseline LBBB was associated with a worse outcome (HR 1.25 (95% CI 1.01-1.55). New LBBB was an independent adverse prognostic feature (HR 2.09 (95% CI 1.17-3.73); P=0.013).
CONCLUSIONS: The crude incidence of LBBB is 10.9% in the first year of follow up in an unselected population of ambulatory outpatients with chronic stable heart failure. Ongoing care of patients with chronic heart failure should include a regular 12 lead electrocardiogram.
Authors:
Andrew L Clark; Kevin Goode; John G F Cleland
Publication Detail:
Type:  Journal Article     Date:  2008-05-22
Journal Detail:
Title:  European journal of heart failure     Volume:  10     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-08     Completed Date:  2008-12-16     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  696-702     Citation Subset:  IM    
Affiliation:
Department of Academic Cardiology, Castle Hill Hospital, Castle Road, Cottingham, Hull, UK. HU16 5JQ, UK. a.l.clark@hull.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Aged
Bundle-Branch Block / epidemiology*,  physiopathology,  ultrasonography
Chi-Square Distribution
Chronic Disease
Echocardiography
Electrocardiography
Female
Great Britain / epidemiology
Heart Failure / epidemiology*,  physiopathology,  ultrasonography
Humans
Incidence
Male
Prevalence
Prognosis
Proportional Hazards Models
Statistics, Nonparametric

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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