New-onset left bundle branch block independently predicts long-term mortality in patients with idiopathic dilated cardiomyopathy: data from the Trieste Heart Muscle Disease Registry

Abstract

After correcting for potential confounders, new-onset LBBB was found to be associated with an increased risk of all-cause mortality. The management of patients with new-onset LBBB may need to be more aggressive, possibly including early cardiac resynchronization therapy/implantable cardioverter-defibrillator therapy.

Evolving concepts in dilated cardiomyopathy

“…6 Importantly, the development of new LBBB during follow-up is a strong independent prognostic predictor of all-cause mortality. 31 Of note, CRT was shown to reduce the risk induced by LBBB, specifically in DCM patients, 25,26 and should timely be considered after LBBB development during follow-up. • The onset of atrial fibrillation during the follow-up is a sign of structural disease progression and negatively impacts the prognosis of these patients, despite effective treatments.…”

“…Patients with DCM and haemodynamically important mitral regurgitation may require invasive therapeutic strategies such as percutaneous repair of the mitral valve, mechanical circulatory support, or even heart transplantation. LBBB is a frequent electrocardiographic marker at diagnosis and is negatively associated with the likelihood of LVRR . Importantly, the development of new LBBB during follow‐up is a strong independent prognostic predictor of all‐cause mortality . Of note, CRT was shown to reduce the risk induced by LBBB, specifically in DCM patients, and should timely be considered after LBBB development during follow‐up. The onset of atrial fibrillation during the follow‐up is a sign of structural disease progression and negatively impacts the prognosis of these patients, despite effective treatments …”

Applicability of a Novel Formula (Bogossian formula) for Evaluation of the QT‐Interval in Heart Failure and Left Bundle Branch Block Due to Right Ventricular Pacing

“…Left bundle branch block (LBBB) is a frequent finding in structural heart disease and is recognized as an independent risk factor for all‐cause mortality in patients with dilated cardiomyopathy . LBBB is regularly associated with a prolonged QT‐interval.…”

“…40 is recognized as an independent risk factor for all-cause mortality in patients with dilated cardiomyopathy. 8 LBBB is regularly associated with a prolonged QT-interval. In the presence of right ventricular (RV) pacing the QT-interval is also prolonged as a result of an altered ventricular activation which is similar to the situation in intrinsic LBBB.…”

Clinical management of dilated cardiomyopathy: current knowledge and future perspectives

“…[9,10] Other variables, including functional mitral regurgitation (FMR), diastolic dysfunction and left bundle branch block (LBBB) or right ventricular (RV) dysfunction, are important indicators of worse outcomes in patients affected by DCM. [11] However their progression or regression during follow-up appears to be more useful prognostic tools than their presence at baseline. [12] The key determinant of the treatments' efficacy is the prevention and reversal of the cardiac remodeling.…”