Long-term mortality predictors in patients with chronic bifascicular block

Area of Science:

• Cardiology
• Electrophysiology
• Internal Medicine

Background:

• Bifascicular block (BFB) is associated with increased mortality risk.
• Previous studies may overestimate cardiac mortality due to patient selection bias.
• Understanding long-term outcomes in BFB is crucial for risk stratification.

Purpose of the Study:

• To determine the long-term mortality rate in patients with bifascicular block.
• To identify independent risk factors for mortality in BFB patients.
• To clarify cardiac mortality predictors in this population.

Main Methods:

• Prospective study of 259 consecutive BFB patients from March 1998 to December 2006.
• Median follow-up of 4.5 years, including electrophysiological study for 82% of patients.
• Statistical analysis to identify independent predictors of total and cardiac mortality.

Main Results:

• Overall mortality was 20.1% (53/259) over the follow-up period, with 7% (19/259) due to cardiac causes.
• Independent predictors of total mortality included age, NYHA class ≥II, atrial fibrillation, and renal dysfunction.
• NYHA class ≥II and renal failure were independent predictors of cardiac mortality.

Conclusions:

• Long-term total and cardiac mortality rates in BFB patients are lower than previously reported.
• Advanced NYHA class and renal failure are significant predictors of cardiac mortality in BFB.
• No independent predictors for arrhythmic death were identified in this cohort.