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Sudden death in patients with chronic bifascicular block
Insights
Sudden cardiac death (SCD) is a significant risk for patients with chronic bifascicular block. Coronary disease and ventricular arrhythmias increase this risk, often due to ventricular fibrillation.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Chronic bifascicular block is a condition affecting cardiac electrical conduction.
- Sudden cardiac death (SCD) poses a significant mortality risk in these patients.
Purpose of the Study:
- To determine the incidence and predictors of SCD in patients with chronic bifascicular block.
- To investigate the underlying mechanisms contributing to SCD in this population.
Main Methods:
- Prospective follow-up of 277 patients with chronic bifascicular block.
- Comparison of clinical, electrocardiographic, and echocardiographic data between patients who experienced SCD and survivors.
- Analysis of mortality rates at one, two, and three years.
Main Results:
- 30 out of 277 patients experienced SCD within the follow-up period.
- SCD patients had higher rates of angina, prior myocardial infarction, heart failure, cardiomegaly, left bundle-branch block, premature ventricular beats, and ventricular tachycardia.
- Ventricular fibrillation was identified as the cause of death in documented cases.
Conclusions:
- SCD is a major cause of mortality in chronic bifascicular block patients.
- Coronary artery disease and ventricular dysrhythmias are associated with increased SCD risk.
- Ventricular fibrillation appears to be a frequent mechanism underlying SCD in this cohort.
Abstract:
Prospective follow-up studies of 277 patients with chronic bifascicular block showed that 30 patients developed sudden cardiac death (SCD). Cumulative one-, two-, and three-year SCD mortality was computed. The patients that developed SCD were compared with the remaining patients (209 alive and 38 dead). The groups were similar in regard to age, sex, AH, and HV intervals. The following were more frequent in the SCD group (P less than .05): angina, previous myocardial infarction, heart failure, cardiomegaly, left bundle-branch block, premature ventricular beats, and ventricular tachycardia. Ventricular fibrillation was the cause of death in four cases of SCD where terminal ECG documentation was available. We concluded that SCD is a major cause of mortality in patients with chronic bifascicular block. The association of SCD with coronary disease and ventricular dysrhythmia suggested ventricular fibrillation as a frequent mechanism.