Left bundle branch block and coronary artery disease

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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Journal of Electrocardiology

|January 1, 1975

Insights

Left bundle-branch block (LBBB) is linked to various conditions, not solely coronary artery disease (CAD). This study suggests LBBB may indicate other cardiac issues, including hypertension cardiomyopathy and aortic valvular disease.

Area of Science:

Cardiology
Electrophysiology

Background:

Left bundle-branch block (LBBB) has been historically associated with coronary artery disease (CAD).
Previous studies investigating this correlation may have been influenced by patient selection bias.
The diverse etiologies of LBBB necessitate a broader understanding beyond CAD.

Purpose of the Study:

To investigate the relationship between left bundle-branch block (LBBB) and coronary artery disease (CAD).
To explore other potential underlying conditions associated with LBBB.
To identify novel patient groups presenting with LBBB.

Main Methods:

Retrospective analysis of patients with left bundle-branch block (LBBB).
Coronary angiography was performed to assess for coronary artery disease (CAD).
Evaluation of patient histories for anginal symptoms and other cardiac risk factors.

Main Results:

Left bundle-branch block (LBBB) is associated with multiple cardiac conditions, including CAD, hypertension cardiomyopathy, and aortic valvular disease.
LBBB can also occur during acute myocardial infarction or as an isolated benign finding.
A significant proportion of female patients with LBBB and anginal symptoms showed no demonstrable CAD.
A statistically significant association was confirmed between LBBB and a shorter left coronary artery (LCA) mainstem.

Conclusions:

Left bundle-branch block (LBBB) is not exclusively indicative of coronary artery disease (CAD).
LBBB may serve as a marker for diverse cardiac pathologies.
Further research is warranted to characterize the newly identified group of LBBB patients, particularly women without obstructive CAD.

Read full analysis

Abstract:

This study tries the concept that left bundle-branch block (LBBB) connotes coronary artery disease (CAD). The findings indicate that prior studies both supporting of and in contradiction to the premise of a positive correlation have been biased by pre-selection of the patients reviewed. The data indicate, therefore, that LBBB is related to multiple entities. The major categories are CAD and/or hypertension myocardiopathy and aortic valvular disease. In addition, LBBB may develop during the acute phase of myocardial infarction. Its existence as a wholly benign entity has been documented as well. Further, this study adds still another group with LBBB. Six of the nine LBBB patients were female. Five of these, in spite of typical anginal histories, had no arteriographically demonstrable CAD. The absence of disease was surprising and the incidence of women with LBBB was greater than anticipated, thus providing some basis for suggesting that these women may be representative of still another group with LBBB. Further, this study supports the findings of Lewis et al by confirming an association between LBBB and a statistically shorter LCA mainstem (p less than 0.001).

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