New-onset left bundle branch block independently predicts long-term mortality in patients with idiopathic dilated cardiomyopathy: data from the Trieste Heart Muscle Disease Registry. Issue 10 (18th February 2014)

• Record Type: Journal Article
• Authors: Aleksova, Aneta; Carriere, Cosimo; Zecchin, Massimo; Barbati, Giulia; Vitrella, Giancarlo; Di Lenarda, Andrea; Sinagra, Gianfranco
• Is Part Of: Europace. Volume 16:Issue 10(2014:Oct.)
• Page Start: 1450
• Page End: 1459
• Publication Date: 2014-02-18
• Subjects: Idiopathic dilated cardiomyopathy -- Heart failure -- Left bundle branch block -- Prognosis; Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/euu016
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract : Aims: Left bundle branch block (LBBB) is commonly associated with heart failure. We evaluated the prevalence, incidence, and impact of LBBB on long-term outcome in young patients with heart failure affected by idiopathic dilated cardiomyopathy (DCM). Methods and results: We included 608 patients with DCM from the Heart Muscle Disease Registry of Trieste in this retrospective analysis. At baseline electrocardiogram (ECG), 189 patients (31.1%) had LBBB. The patients with baseline LBBB had a significantly higher mortality rate than the patients without LBBB (38.6 vs. 27.9%, P = 0.002) at the univariate analysis. After a multiple covariate adjustment, the baseline LBBB was not associated with a significantly increased risk of death [hazard ratio (HR) 1.27, 95% confidence interval (CI): 0.88–1.81, P = 0.2]. Forty-seven (11.2%) patients without LBBB at baseline ECG developed LBBB during follow-up. Among these, the mortality rate was 49 vs. 25% in patients without new-onset LBBB ( P = 0.001). New-onset LBBB was a strong and independent predictor of all-cause mortality (HR 3.18, 95% CI: 1.90–5.31, P < 0.001) at multivariate analysis. Conclusion: After correcting for potential confounders, new-onset LBBB was found to be associated with an increased risk of all-cause mortality. The management of patients with new-onset LBBB may need to be more aggressive, possibly including early cardiac resynchronization therapy/implantable cardioverter-defibrillator therapy.