Association between atrial fibrillation and bundle branch block

Abstract

Background The association between atrial fibrillation (Afib) and sinus and AV nodal dysfunction has previously been reported. However, no data are available regarding the association between Afib and bundle branch block (BBB). Methods Patient data were obtained from the Nationwide Inpatient Sample (NIS) database between years 2009 and 2015. Patients with a diagnosis of Afib and BBB were identified using validated International Classification of Diseases, 9th revision, and Clinical Modification (ICD‐9‐CM) codes. Statistical analysis using the chi‐square test and multivariate linear regression analysis were performed to determine the association between Afib and BBB. Results The total number of patients with BBB was 3,116,204 (1.5%). Patients with BBB had a mean age of 73.5 ± 13.5 years, 53.6% were males, 39.1% belonged to the age group ≥80 years, and 72.9% were Caucasians. The prevalence of Afib was higher in the BBB group, as compared to the non‐BBB group (29% vs 11.8%, p value<.001). This association remained significant in multivariate regression analysis with an odds ratio of 1.25 (CI: 1.24‐1.25, P < .001). Among the subtypes of BBB, Afib was comparatively more associated with RBBB (1.32, CI 1.31‐1.33, p value<.0001) than LBBB (1.17, CI 1.16‐1.18, p value<.0001). The mean cost was higher among Afib with BBB, compared with Afib patients without BBB ($15 795 vs $14 391, p value<.0001). There was no significant difference in the mean length of stay (5.6 vs 5.9 days, p value<.0001) or inpatient mortality (4.9% vs 4.8%). Conclusion This study demonstrates that prevalence of Afib is higher in patients with BBB than without BBB. Cost are higher for Afib patients with BBB, compared to those without BBB, with no significant increase in mortality or length of stay.

Catheter ablation of atrial fibrillation in patients with left bundle branch block

“…In multiple regression analysis, AF was independently associated with LBBB. 3 In another study, 25,268 patients from 106 centers in the United States with left ventricular (LV) dysfunction were enrolled. After adjusting for potential AF risk factors, QRS duration remained independently associated with AF.…”

“…The prevalence of LBBB in this study was lower than that in the literature. 3 However, this study was the largest study of patients with AF and LBBB who underwent catheter ablation of AF up to now. The possible explanation was the patients with LBBB who had poor health condition such as severe heart failure, and the very elderly were excluded from undergoing catheter ablation.…”

“…It was found that the prevalence of left bundle branch block (LBBB) in patients with AF was 1.7% and the prevalence of AF in the LBBB population was 30.5%. 3 Catheter ablation is a well-established therapy for patients with symptomatic AF who were failed or intolerant to antiarrhythmic drugs. 4 It has been proved to be an effective option to maintain sinus rhythm and improve the quality of life in patients with AF.…”

“…LBBB and AF are commonly coexisting conditions. It was found that the prevalence of left bundle branch block (LBBB) in patients with AF was 1.7% and the prevalence of AF in the LBBB population was 30.5% 3 …”

Clinical In-Hospital Outcomes of Acute Myocardial Infarction in Patients With Hematological Malignancies

“…This has been explained in detail in previous studies [ 3 , 4 ]. The International Classification of Disease, 9th revision, Clinical Modification (ICD 9-CM) codes were used to identify diagnosis in the NIS database [ 5 , 6 ]. Data included in this study were obtained between January 2009 and December 2014.…”