Predictive Factors for New-Onset Left Bundle Branch Block in Patients with Left Ventricular Systolic Dysfunction and...

Area of Science:

• Cardiology
• Electrophysiology
• Heart Failure Research

Background:

• Left ventricular systolic dysfunction (LVSD) is associated with structural heart changes.
• The relationship between ventricular remodeling and the development of left bundle branch block (LBBB) in LVSD requires further clarification.

Purpose of the Study:

• To investigate the predictors of new-onset LBBB in patients with LVSD.
• To evaluate the prognostic implications of new-onset LBBB in this patient cohort.

Main Methods:

• Prospective study enrolling 801 hospitalized patients with LVSD (ejection fraction < 50%).
• Assessed new-onset LBBB and a composite endpoint including heart failure hospitalization, mortality, ventricular tachycardia, or ICD/CRT implantation.
• Utilized multivariate Cox regression and Kaplan-Meier survival analysis.

Main Results:

• New-onset LBBB occurred in 10.1% of patients over a median follow-up of 56 months.
• Independent predictors of new LBBB included dilated cardiomyopathy (DCM), coronary artery disease (CAD), paroxysmal atrial fibrillation (PAF), increased QRS duration, and left ventricular end-diastolic dimension (LVEDD).
• New-onset LBBB was associated with significantly higher rates of adverse outcomes, including composite endpoints, heart failure hospitalizations, and ventricular arrhythmias requiring device implantation.

Conclusions:

• DCM, LVEDD, CAD, PAF, and QRS duration are significant predictors for developing LBBB in LVSD patients.
• New-onset LBBB serves as an independent marker for a poor prognosis in patients with LVSD.