Clinical Presentations and Outcomes in Patients Presenting With Acute Cardiac Events and Right Bundle Branch Block

Published on 2019-12-07T13:09:26Z (GMT) by
<div><p>We conducted a retrospective analysis of 50 974 patients admitted with acute cardiac events with and without right bundle branch block (RBBB) over 23 years. Compared to non-RBBB, patients with RBBB (n = 386; 0.8%) were 3 years older (<i>P</i> = .001), more likely to present with breathlessness rather than chest pain (<i>P</i> = .001), and had more diabetes mellitus (<i>P</i> = .001). Patients with RBBB had significantly higher cardiac enzymes (<i>P</i> = .001); however, there were no significant differences in the presentation with ST-segment elevation myocardial infarction (24.6% vs 22.2%), non-ST-segment elevation myocardial infarction (23.7% vs 22.4%), and unstable angina (51.7% vs 55.4%). Patients with RBBB were more likely to have congestive heart failure (CHF; 9.6% vs 3.2%, <i>P</i> = .001), cardiogenic shock (10.6% vs 1.7%, <i>P</i> = .001), and ventricular tachyarrhythmias (7.3% vs 2.2%, <i>P</i> = .001). Left ventricular ejection fraction and hospital length of stay were comparable between the groups. All-cause mortality was 5 times greater in patients with RBBB (21% vs 4.2%, <i>P</i> = .001). Right bundle branch block was independent predictor of mortality (adjusted odd ratio 5.14; 95% confidence interval: 3.90-6.70). Subanalysis comparing normal QRS, RBBB, and left BBB showed that RBBB was associated with the worst outcomes except for CHF. Although RBBB presents in only about 1% of patients with cardiac disease, it was found to be an independent predictor of hospital mortality.</p></div>

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Alkindi, Fahad; El-Menyar, Ayman; Rafie, Ihsan; Arabi, Abdulrahman; Al Suwaidi, Jassim; Singh, Rajvir; et al. (2019): Clinical Presentations and Outcomes in Patients Presenting With Acute Cardiac Events and Right Bundle Branch Block. SAGE Journals. Collection. https://doi.org/10.25384/SAGE.c.4773905.v1