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[Exercise-induced left bundle-branch block in patients with coronary artery disease versus patients with normal

Jaume Candell Riera1, Guillermo Oller Martínez, Juan Vega

  • 1Servicios de Cardiología y Medicina Nuclear. Hospital Universitari Vall d'Hebron. Barcelona. Spain. jcandell@hg.vhebron.es

Revista Espanola De Cardiologia
|May 23, 2002
PubMed

Insights

Exercise-induced left bundle-branch block with normal coronary arteries has a good prognosis, though permanent block may develop. Patients with coronary artery disease face higher risks.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Exercise Physiology

Background:

  • Exercise-induced left bundle-branch block (LBBB) can occur without coronary artery disease.
  • Understanding the clinical course of rate-dependent LBBB is crucial for patient management.

Purpose of the Study:

  • To analyze the clinical characteristics and long-term evolution of patients diagnosed with exercise-induced LBBB.
  • To differentiate outcomes based on the presence or absence of coronary artery disease.

Main Methods:

  • Retrospective analysis of 9,318 exercise stress tests.
  • Detailed review of 20 patients with exercise-induced LBBB who underwent coronary angiography.
  • Mean follow-up duration of 6.9 years.

Main Results:

  • Eight patients had normal coronary arteries (Group A), 12 had coronary artery disease (Group B).
  • Group A showed higher peak oxygen consumption and heart rate at block onset (132 bpm vs 95 bpm).
  • Group A patients with chest pain and normal coronaries had a good prognosis, but 5 developed permanent LBBB; Group B had 3 deaths and 2 myocardial infarctions.

Conclusions:

  • Patients with exercise-induced LBBB and normal coronary arteries generally have a favorable prognosis, especially when experiencing chest pain.
  • Permanent LBBB is a frequent outcome in patients with normal coronary arteries.
  • Atrioventricular block is a rare but possible complication in patients with exercise-induced LBBB.
Abstract

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