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Related Experiment Videos

Exercise dependent complete left bundle branch block.

H Hertzeanu1, L Aron, R J Shiner

  • 1Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.

European Heart Journal
|November 1, 1992
PubMed
Summary
This summary is machine-generated.

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Exercise-dependent complete left bundle branch block (CLBBB) has a good prognosis when no underlying heart disease is found. CLBBB occurring at a heart rate below 125 bpm may not indicate coronary artery disease.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Exercise-dependent complete left bundle branch block (CLBBB) is a rare condition.
  • The clinical significance and prognostic implications of CLBBB require further elucidation.

Purpose of the Study:

  • To evaluate the clinical presentation, diagnostic findings, and long-term prognosis of patients with exercise-dependent CLBBB.
  • To determine if exercise-dependent CLBBB, particularly at lower heart rates, is indicative of underlying coronary artery disease (CAD).

Main Methods:

  • A cohort of eleven patients with exercise-dependent CLBBB was followed for 2-13 years.
  • Investigations included clinical examination, ECG, exercise testing, echocardiography, radionuclide ventriculography, Holter monitoring, and coronary angiography.
  • Heart rate at onset and offset of CLBBB was recorded.

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Main Results:

  • Four patients reported chest pain on exertion, one with palpitations.
  • Coronary angiography revealed significant CAD in three patients (three-vessel disease in two, LAD obstruction in one).
  • Seven patients had normal investigations, including coronary angiography; their CLBBB heart rate decreased over follow-up without proven CAD.

Conclusions:

  • Exercise-dependent CLBBB has a favorable prognosis in the absence of detectable heart disease.
  • Chest pain in patients with exercise-dependent CLBBB does not invariably signify CAD.
  • Exercise-dependent CLBBB occurring at heart rates below 125 bpm may not be an independent marker for CAD.