Related Experiment Video

Updated: Dec 24, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

10.8K

Prognostic impact of bundle branch blocks in patients with ST-segment elevation myocardial infarction

Flora Ozkalayci1, Erdem Turkyilmaz2, Bernas Altıntaş3

  • 1Hisar Intercontinental Hospital, Istanbul, Turkey.

Acta Cardiologica
|April 15, 2020
PubMed

Insights

New or old bundle branch blocks (BBB) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI) are linked to worse outcomes. New onset left bundle branch block (LBBB) is the strongest predictor of major adverse cardiovascular events (MACE).

Area of Science:

  • Cardiology
  • Internal Medicine
  • Medical Research

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring immediate intervention.
  • Bundle branch blocks (BBB) can complicate STEMI, potentially affecting patient outcomes.
  • Understanding the impact of different BBB types and onset times is crucial for risk stratification.

Purpose of the Study:

  • To determine and compare short-term outcomes of all bundle branch block (BBB) types based on onset time.
  • To analyze outcomes in ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (pPCI).
  • To identify predictors of major adverse cardiovascular events (MACE) in this patient cohort.

Main Methods:

  • Retrospective evaluation of 3,057 STEMI patients who underwent pPCI.
  • ECG analysis to identify BBB and classify onset timing (new, old, indeterminate).
  • One-month follow-up to assess composite MACE (death, recurrent MI, stroke).

Main Results:

  • 134 patients (4.4%) had LBBB, and 120 (3.9%) had RBBB.
  • MACE occurred in 7.6% of patients within one month.
  • New onset LBBB was the strongest predictor of MACE (OR: 13.1, p < 0.001), with all BBB types except old RBBB associated with increased MACE compared to non-BBB.

Conclusions:

  • All bundle branch blocks, except for old RBBB, are associated with increased MACE in STEMI patients post-pPCI.
  • New onset LBBB is a significant predictor of adverse cardiovascular events at one month.
  • Timing and type of BBB are critical factors in STEMI prognosis.
Abstract

Keywords:
Bundle branch blockST-elevation myocardial infarctionprimary percutaneous coronary intervention

More Related Videos

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis18:11

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

24.6K
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

9.6K

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
582
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
294
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
146
Heart Failure Drugs: &#946;-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
677
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
190
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
283