![]() The prognostic impact of LBBB and NSIVCD was affected by the definition of the conduction disorder. Other IVCDs had no significant impact on prognosis. In a population study with long-term follow-up, NSIVCD and Minnesota definition of LBBB were independently associated with CV mortality. The presence of R-R’ pattern was not associated with any adverse outcome. While right bundle branch block, left anterior fascicular block and incomplete bundle branch blocks were associated with seemingly higher mortality, this was no longer the case after adjustment for age and sex. Subjects with NSIVCD were associated with twofold to threefold increase in CV mortality depending on the definition. After controlling for known clinical risk factors, the hazard ratio for CV death, compared with individuals without IVCD, was 1.55 for the Minnesota definition of LBBB (95% confidence interval 1.04–2.31, p = .032) and 1.27 (95% confidence interval 0.80–2.02, p = .308) for the Strauss’ definition of LBBB. Resultsĭuring 16.5 years’ follow-up, 1,309 of the 6,299 subjects (20.8%) died and of these 655 (10.4%) were cardiovascular (CV) deaths. For left bundle branch block (LBBB) and non-specific IVCD (NSIVCD), two different definitions were used. We studied long-term prognostic impact and the association with comorbidities of eight IVCDs in a random sample of 6,299 Finnish subjects (2,857 men and 3,442 women, mean age 52.8, SD 14.9 years) aged 30 or over who participated in the health examination including 12-lead ECG. LBBB has no additive predictive value in AHF requiring hospitalization.Previous population studies have presented conflicting results regarding the prognostic impact of intraventricular conduction delays (IVCD). RBBB predicts mortality in de novo AHF, and IVCD in ADCHF. Conclusions Conduction abnormalities predict long-term survival differently in de novo AHF and ADCHF. The main results were confirmed in a validation cohort of 1511 AHF patients with 5.9 years’ mean follow-up. LBBB showed no association with increased mortality in either of the subgroups. Both findings were pronounced in patients with reduced ejection fraction. The impact of RBBB on prognosis was prominent in de novo AHF (adjusted HR 1.93, 1.03–3.60 P = 0.04), and IVCD independently predicted death in ADCHF (adjusted HR 1.79, 1.28–2.52 P = 0.001). ![]() Mortality during the follow-up was higher in patients with RBBB (85.4%) and IVCD (73.7%) compared with patients with normal ventricular conduction (57.0%) P<0.001 for both. 13.2% (P = 0.001), respectively, and RBBB was almost equally common (6.9% and 8.1% P = 0.5), respectively. LBBB, and IVCD were more common in ADCHF than in de novo AHF: 17.2% vs. Half (51.5%, n = 506) of the patients had de novo AHF. Methods and Results We analysed the admission electrocardiogram of 982 patients from a multicenter European cohort of AHF with 3.9 years’ mean follow-up. Our aim was to investigate electrocardiographic predictors of long-term survival in patients with de novo AHF and acutely decompensated chronic heart failure (ADCHF). cardiosurgeryĪcute heart failure Ventricular conduction Bundle branch block Prognosis de novoĪims Data on the prognostic role of left and right bundle branch blocks (LBBB and RBBB), and nonspecific intraventricular conduction delay (IVCD QRS 110 ms, no BBB) in acute heart failure (AHF) are controversial.
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