Risk factor implications of incidentally discovered uncomplicated bundle branch block

Wayne L. Miller, Karla V. Ballman, David O. Hodge, Richard J. Rodeheffer, Stephen C. Hammill

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the long-term outcome of a community-based patient population with incidentally discovered asymptomatic and uncomplicated bundle branch block (BBB). PATIENTS AND METHODS: A retrospective observational cohort study was undertaken of patients in Olmsted County, Minnesota, who were evaluated between 1975 and 1999 and were incidentally diagnosed as having BBB. We performed Kaplan-Meier analyses of all-cause mortality and development of first cardiac morbidity after the diagnosis of BBB, along with matched control group comparisons. RESULTS: A total of 723 patients with left BBB (LBBB) (58.1%) and right BBB (41.9%) met criteria. Mortality was higher in patients with BBB compared with controls (absolute difference of approximately 10% over 20 years; hazard ratio = 1.27; confidence interval, 1.02-1.58; P=.03) as was the development of first cardiac-related morbidity (hazard ratio = 1.32; confidence interval, 1.14-1.54; P<.001). Patients with BBB and without the risk factors of diabetes, hypertension, and/or hypercholesterolemia showed increased long-term mortality compared with matched controls (no BBB) also without risk factors (P=.02). However, comparable mortality was shown between patients with BBB who did not have these risk factors and matched control patients who had these risk factors. The risk of developing cardiac-related morbidity also was increased in the presence of BBB, particularly LBBB. CONCLUSIONS: Uncomplicated asymptomatic BBB (notably LBBB) with normal left ventricular ejection fraction is not benign. Our findings indicate that the presence of isolated BBB denotes a high-risk patient subgroup that has a compromised long-term outcome comparable to patients with conventional cardiovascular risk factors.

Original languageEnglish (US)
Pages (from-to)1585-1590
Number of pages6
JournalMayo Clinic Proceedings
Volume80
Issue number12
StatePublished - 2005

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Bundle-Branch Block
Mortality
Morbidity
Confidence Intervals
Kaplan-Meier Estimate
Hypercholesterolemia
Stroke Volume
Observational Studies
Cohort Studies
Research Design

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Miller, W. L., Ballman, K. V., Hodge, D. O., Rodeheffer, R. J., & Hammill, S. C. (2005). Risk factor implications of incidentally discovered uncomplicated bundle branch block. Mayo Clinic Proceedings, 80(12), 1585-1590.

Risk factor implications of incidentally discovered uncomplicated bundle branch block. / Miller, Wayne L.; Ballman, Karla V.; Hodge, David O.; Rodeheffer, Richard J.; Hammill, Stephen C.

In: Mayo Clinic Proceedings, Vol. 80, No. 12, 2005, p. 1585-1590.

Research output: Contribution to journalArticle

Miller, WL, Ballman, KV, Hodge, DO, Rodeheffer, RJ & Hammill, SC 2005, 'Risk factor implications of incidentally discovered uncomplicated bundle branch block', Mayo Clinic Proceedings, vol. 80, no. 12, pp. 1585-1590.
Miller WL, Ballman KV, Hodge DO, Rodeheffer RJ, Hammill SC. Risk factor implications of incidentally discovered uncomplicated bundle branch block. Mayo Clinic Proceedings. 2005;80(12):1585-1590.
Miller, Wayne L. ; Ballman, Karla V. ; Hodge, David O. ; Rodeheffer, Richard J. ; Hammill, Stephen C. / Risk factor implications of incidentally discovered uncomplicated bundle branch block. In: Mayo Clinic Proceedings. 2005 ; Vol. 80, No. 12. pp. 1585-1590.
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AB - OBJECTIVE: To evaluate the long-term outcome of a community-based patient population with incidentally discovered asymptomatic and uncomplicated bundle branch block (BBB). PATIENTS AND METHODS: A retrospective observational cohort study was undertaken of patients in Olmsted County, Minnesota, who were evaluated between 1975 and 1999 and were incidentally diagnosed as having BBB. We performed Kaplan-Meier analyses of all-cause mortality and development of first cardiac morbidity after the diagnosis of BBB, along with matched control group comparisons. RESULTS: A total of 723 patients with left BBB (LBBB) (58.1%) and right BBB (41.9%) met criteria. Mortality was higher in patients with BBB compared with controls (absolute difference of approximately 10% over 20 years; hazard ratio = 1.27; confidence interval, 1.02-1.58; P=.03) as was the development of first cardiac-related morbidity (hazard ratio = 1.32; confidence interval, 1.14-1.54; P<.001). Patients with BBB and without the risk factors of diabetes, hypertension, and/or hypercholesterolemia showed increased long-term mortality compared with matched controls (no BBB) also without risk factors (P=.02). However, comparable mortality was shown between patients with BBB who did not have these risk factors and matched control patients who had these risk factors. The risk of developing cardiac-related morbidity also was increased in the presence of BBB, particularly LBBB. CONCLUSIONS: Uncomplicated asymptomatic BBB (notably LBBB) with normal left ventricular ejection fraction is not benign. Our findings indicate that the presence of isolated BBB denotes a high-risk patient subgroup that has a compromised long-term outcome comparable to patients with conventional cardiovascular risk factors.

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