Key result
An initially abnormal HV interval (≥55 ms) in incomplete bundle-branch block complicating acute MI was associated with 65% mortality versus 20% for a normal interval (not statistically significant).
Why the study?
What are the electrocardiographic predictors of long-term survival in patients with incomplete bilateral bundle-branch block complicating acute myocardial infarction?
Cohort (n=28)
What are the electrocardiographic predictors of long-term survival in patients with incomplete bilateral bundle-branch block complicating acute myocardial infarction?
Absolute Event Rate: 65% vs 20%
p-value: p=not statistically significant
Long-term survival is possible after incomplete bilateral bundle-branch block complicating acute myocardial infarction and is associated with an initially normal HV interval, transient block, and a decreasing HV interval if initially abnormal.
Hypothesis-generating for HV interval as mortality predictor in incomplete BBB post-MI; larger prospective studies needed before clinical adoption.
Electrocardiograms and His bundle electrograms were reviewed in 28 patients with incomplete bilateral bundle-branch block complicating acute myocardial infarction. All had a His bundle electrogram at the time of pacemaker insertion; 10 had a second one. Of 23 patients with an initially abnormal HV interval (55 ms or greater), 15 died (65%), while only one died (20%) in the group of 5 with a normal HV interval. This difference is not statistically significant. Sequential His bundle electrograms were done in 6 of the 8 survivors with an initially abnormal HV interval, and 4 showed 10 to 15 ms decrease in HV interval. The disappearance of incomplete bilateral bundle-branch block occurred significantly more often in patients who survived (7 of 12) when compared with those who did not survive (2 of 16) (P less than 0.05). It is concluded that long-term survival is po-sible after incomplete bilateral bundle-branch block complicating acute myocardial infarction. The characteristics of the survivors include an initially normal HV interval, transient incomplete belateral bundle-branch block and a decreasing HV interval if it were initially abnormal.
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Lichstein et al. (1975) conducted a cohort in Incomplete bilateral bundle-branch block complicating acute myocardial infarction (n=28). Abnormal HV interval (≥55 ms) vs. Normal HV interval was evaluated on Death (p=not statistically significant). An initially abnormal HV interval (≥55 ms) in incomplete bundle-branch block complicating acute MI was associated with 65% mortality versus 20% for a normal interval (not statistically significant).