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Ventricular conduction defects and the risk of incident heart failure in the Atherosclerosis Risk in Communities

Zhu-Ming Zhang1, Pentti M Rautaharju1, Ronald J Prineas1

  • 1Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Journal of Cardiac Failure
|January 14, 2015
PubMed

Insights

Ventricular conduction defects (VCDs), excluding isolated right bundle branch blocks (RBBB), significantly increase heart failure (HF) risk. Prolonged QRS duration, especially over 140 ms, further elevates this risk.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Public Health

Background:

  • Heart failure (HF) is a major public health concern.
  • Ventricular conduction defects (VCDs) are common cardiac abnormalities.
  • The association between specific VCDs and incident HF risk requires further elucidation.

Purpose of the Study:

  • To assess the risk of incident heart failure (HF) across different categories of ventricular conduction defects (VCDs).
  • To investigate the impact of QRS duration on the risk of developing HF.

Main Methods:

  • Analysis of 14,478 participants from the Atherosclerosis Risk in Communities (ARIC) study, free of HF at baseline.
  • Categorization of VCDs including right bundle branch block (RBBB), left bundle branch block (LBBB), bifascicular block, and indeterminate-type VCD.
  • Longitudinal follow-up for an average of 18 years to ascertain incident HF hospitalizations.

Main Results:

  • Left bundle branch block (LBBB) and pooled VCDs (excluding lone RBBB) were strongly associated with increased HF risk (HR 2.87 and 2.29, respectively).
  • HF risk escalated with prolonged QRS duration, with pooled VCDs and QRS ≥140 ms showing a 3.25-fold increased risk.
  • Lone RBBB did not demonstrate a significant association with incident HF.

Conclusions:

  • Ventricular conduction defects, excluding isolated RBBB, are significant predictors of incident heart failure.
  • Increasing QRS duration, particularly exceeding 140 ms, substantially elevates the risk of heart failure development.
Abstract

Keywords:
Heart failureQRS durationbundle branch blockelectrocardiography

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