Patients with partial bilateral bundle-branch block have a substantial risk of progressing to complete heart block, highlighting the need for long-term follow-up.
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May support intensified monitoring in partial bilateral bundle-branch block; leaves open optimal intervention timing in randomized trials.
In an 11-year period 209 cases of partial bilateral bundle-branch block were seen. These included patients with right bundle-branch block and either left superior or left inferior intraventricular block. The majority of patients had evidence of coronary artery disease or hypertension, though a significant number had no clinical evidence of heart disease. The majority of patients had follow-up ECG tracings, with an average follow-up for the whole group of about 2 years. The incidence of complete heart block was 14.4% (30 of 209). Complete heart block developed more than 10 years after the discovery of bilateral bundle-branch block in several patients. It is anticipated that with more complete and longer follow-up the incidence of complete heart block will be even higher.
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Scanlon et al. (1970) studied this question.
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