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[Complete bundle branch block during exercise test. Clinical and coronary angiographic data].
J P Bounhoure1, J P Donzeau, J P Doazan
1Service de cardiologie du Pr Bounhoure, CHU Rangueil, Toulouse.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|February 1, 1991
Summary
Complete right bundle branch block during exercise stress tests indicates coronary artery disease. Complete left bundle branch block has a 72% predictive value for coronary artery disease, especially with proximal left anterior descending artery stenosis.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Bundle branch blocks can occur during exercise stress tests.
- The association between exercise-induced bundle branch blocks and coronary artery disease requires further investigation.
Purpose of the Study:
- To investigate the prevalence and significance of exercise-induced bundle branch blocks.
- To determine the correlation between right bundle branch block (RBBB) and left bundle branch block (LBBB) during exercise and coronary artery disease (CAD).
Main Methods:
- Retrospective analysis of 16,500 exercise stress tests.
- Observation of 32 complete bundle branch blocks (7 RBBB, 25 LBBB).
- Coronary angiography and selective left ventriculography in all patients.
Main Results:
- RBBB during exercise was consistently linked to atherosclerotic CAD.
- LBBB during exercise had a 72% predictive value for CAD.
- LBBB at heart rates <120/min often indicated proximal left anterior descending artery stenosis.
Conclusions:
- Exercise-induced RBBB is a strong indicator of CAD.
- Exercise-induced LBBB is a significant predictor of CAD, particularly when occurring at lower heart rates.
- These findings highlight the importance of evaluating coronary anatomy in patients with exercise-induced bundle branch blocks.