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Cited by 20Cardiac pacing and defibrillation studiesCardiac electrophysiology and arrhythmiasCardiovascular Syncope and Autonomic Disorders

Long-term prognosis in patients with bifascicular block–the predictive value of noninvasive and invasive assessment

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TABRIZI, F., ROSENQVIST, M., BERGFELDT, L., ENGLUND, A.·2006·Journal of Internal Medicine
DOI 10.1111/j.1365-2796.2006.01651.x
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Abstract

OBJECTIVES: Patients with bifascicular block (BFB) have a high mortality rate. The purpose of the present study was to identify high-risk patients in a BFB population by performing an extensive cardiac evaluation including noninvasive and invasive tests. DESIGN: Population-based study. SUBJECTS: A total of 100 patients with BFB, of whom 41 had a history of unexplained syncope, were prospectively studied. The mean age was 68 +/- 12. All patients were investigated with Holter-monitoring, an exercise test, an echocardiography, and an invasive electrophysiological study. The severity of congestive heart failure (CHF) was assessed by New York Heart Association (NYHA) classification. Patients in NYHA class IV were excluded. INTERVENTIONS: Patients with syncope were recommended prophylactic pacemaker treatment, which was accepted by 31 patients (76%). Main outcome measures. All-cause mortality and sudden cardiac death (SCD). RESULTS: During a median follow-up of 84 months, 33 patients died, of whom 14 in SCD. In a univariate analysis, high age, a previous myocardial infarction, and CHF were associated with a significantly increased risk of all-cause mortality and SCD. In a Cox multiple regression analysis, CHF was the only independent predictor of all-cause mortality and SCD (P < 0.01). CONCLUSION: Patients with BFB have a poor long-term prognosis. The predictive value of noninvasive and invasive investigations is limited. The only independent predictor of all-cause mortality and SCD in this population was the presence of CHF.

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  • Syncope is not associated with an increased incidence of sudden death in patients with preserved cardiac function.

    “Although syncope is not associated with an increased incidence of sudden death in patients with preserved cardiac function”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [347]

    The 'Congestive heart failure, all-cause mortality, and SCD' results say that CHF was the only independent predictor of sudden cardiac death and that other covariates had no impact. The 'Demographic data' results also find no significant difference in all-cause mortality by syncope status. However, the paper does not report a syncope–sudden-death comparison specifically among patients with preserved cardiac function; its findings concern patients with bifascicular block. (LLM, conf=0.82)

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  • A high incidence of total deaths, about one-third sudden, occurs in patients with bundle branch block and heart failure, previous myocardial infarction, or low ejection fraction.

    “a high incidence of total deaths (about one-third sudden) was observed in patients with BBB and heart failure, previous myocardial infarction, or low ejection fraction. 345-347”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [347]

    The Outcome section (page unavailable) reports 33 deaths among 100 patients with bifascicular block, including 14 sudden deaths—about 42% of deaths, not one-third. The Demographic data, Noninvasive investigations, and Congestive heart failure sections associate previous myocardial infarction, heart failure, and low ejection fraction with mortality or sudden death. The source studies bifascicular block specifically, rather than bundle branch block generally. (LLM, conf=0.88)

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Research works printed but not linked: 1

  1. Correspondence: Fariborz Tabrizi, MD, Department of Cardiology, South Hospital, S-118 83 Stockholm, Sweden. (fax: +4686163040; e-mail: fariborz.tabrizi@sodersjukhuset.se). Ó 2006 Blackwell Publishing Ltd Journal of Internal Medicine 260: 31-38

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Authors
TABRIZI, F., ROSENQVIST, M., BERGFELDT, L., & ENGLUND, A.
Affiliations
  • Karolinska Institutet (SE)
  • Sahlgrenska University Hospital (SE)
  • Örebro University Hospital (SE)
Corresponding author
TABRIZI, F.
ORCID
Venue
Journal of Internal Medicine
Publisher
Wiley
Published
2006-04-21
Volume
260
Issue
1
Pages
31-38
ISSN
  • 0954-6820 (ISSN-L)
  • 1365-2796
DOI
10.1111/j.1365-2796.2006.01651.x
OpenAlex
W1983293995
Cited by
20
References
32
Citations by year
2022: 2 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 4 · 2014: 2 · 2013: 1 · 2012: 2
FWCI
0.95
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
Keywords
bifascicular block, long-term prognosis, sudden cardiac death, all-cause mortality, congestive heart failure, syncope, risk prediction, myocardial infarction
MeSH terms
Aged, Aged, 80 and over, Bundle-Branch Block, Cardiac Pacing, Artificial, Chronic Disease, Epidemiologic Methods, Exercise Test, Female, Heart Failure, Humans, Male, Middle Aged, Prognosis, Syncope, Electrocardiography, Ambulatory, Death, Sudden, Cardiac

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