Effects of left bundle-branch block
on cardiac structure, function, perfusion, and perfusion reserve: implications for myocardial contrast echocardiography versus radionuclide perfusion imaging for the detection of coronary artery disease.
Fresco et al., "Cumulative effect of complete left bundle-branch block
and chronic atrial fibrillation on 1-year mortality and hospitalization in patients with congestive heart failure: a report from the Italian network on congestive heart failure (in-CHF database)," European Heart Journal, vol.
In our post-treatment follow-up, chronic Chagas disease is indicated in three patients on the basis of these ECG findings: left anterior fascicular block, atrioventricular dissociation and intermittent left bundle-branch block
, and right bundle-branch block and left posterior fascicular block, despite there being no clinical manifestation of these conditions.
A 12-lead electrocardiograph (Figure 1) showed atrial fibrillation with ventricular pacemaker spikes associated with right bundle-branch block, rather than the typical pattern of left bundle-branch block
. A subsequent chest X-ray displayed the atrial lead in proper position and the ventricular lead well within the left ventricular silhouette (Figure 2).
(3-5) However, intermediate pretest probability patients with baseline ECG abnormalities such as electronically paced ventricular rhythm or left bundle-branch block
will require myocardial perfusion imaging.
The American College of Cardiology and the American Heart Association revised their guidelines in 1999, elevating early mechanical intervention for cardiogenic shock to a class I recommendation for patients younger than 75 with an ST-elevation left bundle-branch block
Three Risk Factors Predict Mortality in 15,078 Acute MI Patients Number of Risk Factors [*] 0 1 2 3 Percentage of Patients 46 41 11 2 Percent Mortality Within 30 Days 3 6 19 32 (*.) Risk factors are age 75 or older, Killip class II-IV, and ECG findings indicative of an anterior MI and/or left bundle-branch block
. Source: Dr.
The major ECG abnormalities and their frequency were as follows: ventricular tachycardia (3), prolonged QTc (3), 2nd or 3rd atrioventricular block (4), complete left bundle-branch block
(5), acute myocardial infarction (3).
Left bundle-branch block
is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: A report from the Italian network on congestive heart failure.
Chang AM, Shofer FS, Tabas JA, Magid DJ, McCusker CM, Hollander JE (2009) Lack of association between left bundle-branch block
and acute myocardial infarction in symptomatic ED patients.
Inclusion criteria: patients with HF, left bundle-branch block
, who had a cardiac resynchronization device implanted.
The aim of this study was to assess electrocardiographic variables related to the ventricular repolarization process in patients during atrial-biventricular pacing (from cardiac resynchronization therapy received as an adjunct management strategy for severe congestive heart failure associated with left bundle-branch block
), by using the non-invasive method of body surface potential mapping.