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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

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Differences in presentation and clinical outcomes between left or right bundle branch block and ST segment elevation

Matthias R Meyer1,2, Dragana Radovanovic3, Giovanni Pedrazzini4

  • 1Division of Cardiology, Triemli Hospital Zurich, Switzerland.

European Heart Journal. Acute Cardiovascular Care
|February 8, 2020
PubMed

Insights

Bundle branch block in acute myocardial infarction patients indicates higher risk but does not independently increase mortality. Mortality is only elevated with right bundle branch block and ST segment elevation.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Medical Research

Background:

  • Bundle branch blocks (BBB) in acute myocardial infarction (AMI) may worsen prognosis.
  • Clinical presentation and outcomes of AMI with left bundle branch block (LBBB) or right bundle branch block (RBBB) are not well-defined.

Purpose of the Study:

  • To characterize the clinical presentation and outcomes of AMI patients with LBBB or RBBB.
  • To compare these outcomes against AMI patients with ST segment elevation (STE) without BBB.

Main Methods:

  • Analysis of 17,034 AMI patients from the Swiss-Plus registry (2008-2019).
  • Patients were categorized into LBBB (n=880), RBBB (n=732), or STE without BBB (n=15,852).

Main Results:

  • AMI patients with BBB were older and had more comorbidities than those with STE.
  • LBBB was associated with higher rates of pulmonary edema, cardiogenic shock, three-vessel disease, left main disease, and major adverse cardiac and cerebrovascular events (MACCE).
  • After adjustment, LBBB did not independently increase mortality, while RBBB showed lower mortality compared to STE; mortality increased only with RBBB and concomitant STE.

Conclusions:

  • Isolated BBB in AMI patients presents with high-risk characteristics.
  • Isolated BBB does not independently predict increased hospital mortality in AMI.
  • RBBB combined with STE is associated with increased mortality.
Abstract

Keywords:
Acute coronary syndromeST segment elevation myocardial infarctionelectrocardiogramleft bundle branch blockmyocardial infarctionright bundle branch block

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