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Right bundle branch block and long‐term mortality in patients with acute congestive heart failure
Author(s) -
MUELLER C.,
LAULEKILIAN K.,
KLIMA T.,
BREIDTHARDT T.,
HOCHHOLZER W.,
PERRUCHOUD A. P.,
CHRIST M.
Publication year - 2006
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.2006.01703.x
Subject(s) - medicine , hazard ratio , right bundle branch block , heart failure , cardiology , proportional hazards model , comorbidity , electrocardiography , confidence interval
. 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.