What question did this study set out to answer?

To evaluate the clinical course and long-term prognosis of patients with chronic bundle branch block who demonstrate marked prolongation of the H-V interval.

April 1, 1976CirculationOpen Access

Prospective observations in patients with chronic bundle branch block and marked H-V prolongation.

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Population

18 patients with chronic bundle branch block and marked H-V prolongation identified from a cohort of 388…

Design

Cohort

Follow-up

mean 711 +/- 118 days (range 103 to 1919 days)

Authors

RDRamesh C. DhingraUniversity of Illinois Chicago PDP DenesNorthwestern University DWD WuHunan University of Traditional Chinese Medicine

Discussion

Member takes

Implication

Supports no prophylactic pacing in asymptomatic patients with HV ≥80 ms; leaves open pacing benefit in symptomatic cases pending prospective data.

Key Points

To evaluate the clinical course and long-term prognosis of patients with chronic bundle branch block who demonstrate marked prolongation of the H-V interval.
Prospective evaluation of 18 patients identified with H-V intervals of 80 msec or greater from a cohort of 388 patients undergoing electrophysiological evaluation for chronic bundle branch block.
Tracked patients across New York Heart Association functional classes I through IV over a follow-up range of 103 to 1919 days (mean 711 ± 118 days).
Permanent pacing was required in 3 of 18 patients for indications including sino-atrial block, postoperative sinus bradycardia, and second-degree block distal to the His bundle.
Mortality occurred in 6 patients (3 sudden, 3 non-sudden), all of whom had symptomatic heart disease at baseline.
All 5 initially asymptomatic functional class I patients remained alive and free of permanent pacemakers over a mean follow-up of 732 ± 139 days.

Structured PICO

Population

18 patients with chronic bundle branch block and marked H-V prolongation (≥80 msec) identified from a cohort of 388 patients. Functional class I (n=5), II (n=5), III (n=7), and IV (n=1).

Outcome

Clinical course including mortality and need for permanent pacinghard clinical

Marked H-V prolongation (≥80 msec) in chronic bundle branch block is associated with high mortality only in symptomatic patients, whereas asymptomatic patients have a benign course that does not warrant prophylactic pacing.

Limitations

Small series
Longer follow-up needed for definitive prognostication

Cite This Study

Dhingra et al. (1976) studied this question.

synapsesocial.com/papers/6a8a624a176d2ac34cfbd86c https://doi.org/10.1161/01.cir.53.4.600

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Implication

Supports no prophylactic pacing in asymptomatic patients with HV ≥80 ms; leaves open pacing benefit in symptomatic cases pending prospective data.

Prospective observations in patients with chronic bundle branch block and marked H-V prolongation.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Prospective observations in patients with chronic bundle branch block and marked H-V prolongation.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider