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Prevalence of Bundle Branch Block and Axis Deviation in Permanent Atrial Fibrillation and Gender Differences

Raymond Farah1,2, Mor Kdoshim1,2, Rola Khamisy-Farah2,3

  • 1Internal Medicine Department B, Ziv Medical Center, Safed, Israel.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|September 10, 2025
PubMed

Insights

Atrial fibrillation is linked to left bundle branch block, potentially indicating a risk factor. Left axis deviation may be protective, with younger patients showing a stronger association with left bundle branch block, suggesting a poorer prognosis.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Atrial fibrillation (AF) is a common arrhythmia.
  • The association between AF and conduction abnormalities like bundle branch block (BBB) and axis deviation (AD) requires further investigation.

Purpose of the Study:

  • To explore the coexistence and association of right or left bundle branch block and axis deviation in patients with permanent atrial fibrillation compared to healthy subjects in sinus rhythm.
  • To investigate potential correlations between these ECG findings and atrial fibrillation, considering age and sex.

Main Methods:

  • Retrospective observational study at Ziv Medical Center, Israel.
  • Analysis of ECGs from patients with permanent atrial fibrillation and a control group with sinus rhythm.
  • Assessment for the presence of bundle branch block and/or axis deviation.

Main Results:

  • A significant correlation was found between atrial fibrillation and left bundle branch block.
  • Subjects in sinus rhythm showed a significant correlation with left axis deviation.
  • Younger patients (<73.5 years) with AF had a higher correlation with LBBB; older patients (>73.5 years) in sinus rhythm had a higher correlation with LAD.

Conclusions:

  • Left bundle branch block may be a risk factor for atrial fibrillation, while left axis deviation might be protective.
  • Age influences these associations, with younger AF patients showing a significant correlation with LBBB, potentially indicating a poor prognosis.
  • No significant difference was observed between male and female patients regarding these associations.
Abstract

Keywords:
atrial fibrillationbundle branch blockchanging axis deviation

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