Key result
RBBB is not associated with increased one-year mortality in suspected MI.
Why the study?
The new ESC guideline recommends considering left and right bundle branch block equally for urgent angiography in suspected myocardial infarction, but this recommendation requires evaluation.
Does the presence of right bundle branch block (RBBB) predict acute myocardial infarction and mortality in patients presenting to the emergency department with suspected myocardial infarction?
Cohort (n=4,067)
Yes
Does the presence of right bundle branch block (RBBB) predict acute myocardial infarction and mortality in patients presenting to the emergency department with suspected myocardial infarction?
Hazard Ratio: 1.29 (95% CI 0.71–2.34)
Absolute Event Rate: 10.7% vs 3.2%
p-value: p=0.40
While RBBB is a marker of high mortality risk in suspected MI, it does not increase the likelihood of an actual MI diagnosis compared to patients without bundle branch block, challenging its use as a sole trigger for urgent angiography.
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RBBB does not predict higher one-year mortality in suspected MI; leaves open its diagnostic utility and role in urgent angiography decisions.
Neumann et al. (2018) conducted a cohort in Suspected myocardial infarction (n=4,067). Right bundle branch block (RBBB) vs. No bundle branch block was evaluated on Mortality after one year (HR 1.29, 95% CI 0.71-2.34, p=0.40). Right bundle branch block was not significantly associated with increased one-year mortality compared to no block in patients with suspected MI (HR 1.29; 95% CI 0.71-2.34; P=0.40).