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Prognostic Significance of Right Bundle-Branch Block Associated with Acute ST Elevation Myocardial Infarction
1Dr Muhammad Ruhul Amin, Senior Consultant, Department of Cardiology, 250 Beded Mohammad Ali Hospital, Bogura, Bangladesh;
Mymensingh Medical Journal : MMJ
|June 30, 2026
Summary
Right bundle-branch block (RBBB) significantly increases in-hospital mortality for ST-elevation myocardial infarction (STEMI) patients. This condition is also linked to higher rates of heart failure, cardiogenic shock, and arrhythmias.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Right bundle-branch block (RBBB) is a known electrocardiographic finding.
- Its prognostic significance in acute ST-elevation myocardial infarction (STEMI) requires further elucidation, especially considering demographic shifts.
Purpose of the Study:
- To determine the prognostic significance of RBBB in patients experiencing acute STEMI.
- To identify complications associated with RBBB in STEMI patients.
Main Methods:
- A prospective observational study conducted at the National Institute of Cardiovascular Diseases (NICVD), Dhaka.
- 216 acute STEMI patients presenting within 12 hours of chest pain were included and received thrombolysis.
- Patients were divided into two groups: 108 with RBBB (Group I) and 108 without RBBB (Group II).
Main Results:
- In-hospital mortality was significantly higher in Group I (RBBB) at 20.4% compared to Group II (7.5%) (p=0.006).
- Complications like acute heart failure (27.8% vs 13%), cardiogenic shock (16.7% vs 7.5%), ventricular tachycardia (14.8% vs 6.5%), and third-degree AV block (11.1% vs 4.6%) were more frequent in Group I.
- Logistic regression identified RBBB as an independent predictor of in-hospital mortality (RR 1.96, p=0.002).
Conclusions:
- Acute STEMI patients with RBBB exhibit significantly higher in-hospital mortality.
- RBBB is associated with an increased incidence of severe complications, including heart failure, cardiogenic shock, and arrhythmias.
- RBBB, particularly in acute anterior STEMI, is an independent predictor of in-hospital mortality.
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