Abstract
Twenty-one patients with long-term right bundle branch block and left posterior hemiblock were studied electrophysiologically and then followed up prospectively. The group consisted of 19 men and 2 women aged 61 ± 2.7 years (mean ± standard error of the mean). The majority of patients had either hypertensive cardiovascular disease (48 percent) or primary conduction disease (33 percent). Initial electrophysiologic studies revealed A-H intervals of 58 to 152 msec (mean 98 ±7.7) and H-V intervals of 40 to 80 msec (mean 52 ± 2.1). Six patients (29 percent) had prolonged H-V intervals. The follow-up period ranged from 91 to 1,231 days (mean 671 ± 68). Three of 21 patients (14 percent) needed a permanent pacemaker after development of the following symptomatic conduction disease: sinoatrial block on day 3 of follow-up; second degree atrioventricular (A-V) block, site undetermined, on day 118; and second degree A-V block proximal to the His bundle on day 398. One patient died suddenly (on day 571), and two others died of noncardiac causes. In conclusion, combined right bundle branch block and left posterior hemiblock was associated with less trifascicular disease than reported previously. The clinical course of most of the patients was benign and the incidence of sudden death was relatively small. Symptomatic conduction disease occurred but could be definitely related to trifascicular disease in only one patient. These short-term data suggest that prophylactic pacemaker insertion is not routinely indicated in patients with chronic right bundle branch block and left posterior hemiblock.
Original language | English (US) |
---|---|
Pages (from-to) | 867-872 |
Number of pages | 6 |
Journal | The American journal of cardiology |
Volume | 36 |
Issue number | 7 |
DOIs | |
State | Published - Dec 1975 |
Funding
From the Cardiology Section, Abraham Lincoln School of Medicine, University of Illinois College of Medicine: West Side Veterans Administration Hospital and Department of Adult Cardiology, Cook County Hospital, Chicago, III. This study was supported in part by NIH contract 71-2478 under the Myocardiil Infarction Program, National Heart and Lung Institutes, National lnsti-tutes of Health, Bethesda, Md., Cardiology Training Grant HL-05870-05, from the U. S. Public Health Service, Bethesda, Md., and West Side Veterans Administration Hospital, Chicago Basic Institutional Support. Manuscript accepted April 2. 1975.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine