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Bundle branch block in cardiac arrest survivors without ischemic heart disease

Julie Terp Holm1, Niels Kjær Stampe1, Priya Bhardwaj1,2

  • 1Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.

International Journal of Cardiology. Heart & Vasculature
|March 10, 2023
PubMed

Insights

Cardiac arrest survivors with bundle branch block (BBB) but no ischemic heart disease (IHD) were characterized. Left bundle branch block (LBBB) was common, associated with lower ejection fraction, but outcomes did not differ by BBB type.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Public Health

Background:

  • Bundle branch block (BBB) in cardiac arrest (CA) survivors without ischemic heart disease (IHD) is not well-characterized.
  • Understanding heart failure, implantable cardioverter defibrillator (ICD) therapy, and mortality in this specific population is crucial for clinical management.

Purpose of the Study:

  • To describe the characteristics of CA survivors with BBB and no IHD.
  • To analyze heart failure, ICD therapy, and mortality rates in this patient group.
  • To compare outcomes among different BBB subtypes (LBBB, RBBB, NSBBB).

Main Methods:

  • Retrospective analysis of 701 CA survivors who received a secondary prophylactic ICD between 2009 and 2019.
  • Exclusion of patients with congenital or ischemic heart disease (IHD).
  • Characterization of BBB subtypes (LBBB, RBBB, NSBBB) and assessment of left ventricular ejection fraction (LVEF) and mortality during follow-up.

Main Results:

  • 58 CA survivors (8%) without IHD but with BBB were identified; 46 had LBBB (79%).
  • The prevalence of LBBB among all CA survivors was 7%.
  • LBBB patients had significantly lower LVEF at discharge compared to other BBB subtypes (P < 0.001).
  • Mortality did not differ significantly between BBB subtypes during a median follow-up of 3.6 years.

Conclusions:

  • A notable proportion of CA survivors receiving prophylactic ICDs have BBB without underlying IHD.
  • LBBB is prevalent in this cohort and associated with impaired left ventricular function post-cardiac arrest.
  • Despite differing LVEF, ICD therapy and mortality outcomes are similar across BBB subtypes in this population.
Abstract

Keywords:
Bundle Branch Block (BBB)Implantable Cardioverter Defibrillator (ICD)Sudden Cardiac Arrest (SCA)

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