Diagnostic value of programmed ventricular stimulation in patients with bifascicular block: A prospective study of patients with and without syncope

Englund, Anders; Bergfeldt, Lennart; Rehnqvist, Nina; Åström, Hans; Rosenqvist, Mårten

doi:10.1016/0735-1097(95)00354-1

Cited by 87 publications

(39 citation statements)

References 31 publications

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“…17 Moreover, LBBB heightens the risk of life-threatening ventricular arrhythmias and sudden death. 18,19 Given these premises, the high percentage of new-onset LBBB after TAVI spurred interest into whether this conduction disturbance could be associated with a worse prognosis after transcatheter procedures. The present data, from the largest registry to specifically evaluate this question, suggest that new-onset LBBB after TAVI is not associated with a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of Persistent Left Bundle-Branch Block After Transcatheter Aortic Valve Implantation With CoreValve Revalving System

et al. 2013

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Background-Conduction. Survival analyses and inherent log-rank tests showed that LBBB was not associated with higher all-cause mortality, cardiac mortality, or hospitalization for heart failure at 30 days or 1 year. At 30 days, but not at 1 year, group A had a significantly higher rate of pacemaker implantation. Conclusions-In this registry of high-volume centers, persistent LBBB after CoreValve Revalving System transcatheter aortic valve implantation showed no effect on hard end points. On the other hand, LBBB was associated with a higher short-term rate of pacemaker implantation. (Circulation. 2013;127:1300-1307.)Key Words: aortic valve ■ bioprosthesis ■ cardiac pacemaker, artificial ■ left bundle-branch block ■ prognosis

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Section: Discussionmentioning

confidence: 99%

Clinical Impact of Persistent Left Bundle-Branch Block After Transcatheter Aortic Valve Implantation With CoreValve Revalving System

et al. 2013

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“…This theory is supported by electrophysiological studies of patients with bifascicular block, in whom sustained monomorphic ventricular tachycardia was induced exclusively in patients with a previous myocardial infarction. 47 Furthermore, McAnulty et al 3 followed up 554 patients with bundle-branch block and noticed an increased risk of sudden death due not to bradyarrhythmias but rather to tachyarrhythmias and myocardial infarction.…”

Section: Mortalitymentioning

confidence: 99%

Bundle-Branch Block in a General Male Population

et al. 1998

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Background-Interest in bundle-branch block has focused primarily on its role as a predictor of mortality and coexisting cardiovascular diseases. Previous studies of prevalence, correlation to cardiovascular disease, and mortality have produced conflicting results. Methods and Results-We studied a random-sampled population of 855 men who were 50 years old in 1963 and followed them up for 30 years with repeated examinations. Men who developed bundle-branch block were studied with regard to cumulative incidence, relationship with cardiovascular disease/risk factors, and survival. The prevalence of bundle-branch block increases from 1% at age 50 years to 17% at age 80 years, resulting in a cumulative incidence of 18%. No significant relationship with ischemic heart disease or mortality was found. Men who would develop bundle-branch block had a bigger heart volume at age 50 years and developed diabetes mellitus and congestive heart disease during follow-up more often than control subjects. Conclusions-Bundle-branch block correlates strongly to age and is common in elderly men. Our results support the theory that bundle-branch block is a marker of a slowly progressing degenerative disease that also affects the myocardium.(Circulation. 1998;98:2494-2500.)

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“…In patients with negative electrophysiological studies, Link et al 2 observed development of stable AV block in 18% (after 30 months) and Gaggioli et al 3 in 19% (after 62 months) of patients, thus suggesting that some results are false negatives; the syncope recurrence rate was 19% after 2.2 years in one study 4 and Ϸ40% after 3 years in another 2 ; mortality was generally low. 2,4,5 A significant problem in evaluating syncope and bifascicular block is the transient nature of high-degree AV block and the long interval sometimes required to document it electrocardiographically. An implantable event monitor has recently become available and has been validated in patients with unexplained syncope.…”

mentioning

confidence: 99%

Mechanism of Syncope in Patients With Bundle Branch Block and Negative Electrophysiological Test

Brignole¹,

Menozzi²,

Moya³

et al. 2001

Circulation

297

119

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on behalf of the International Study on Syncope of Uncertain Etiology (ISSUE) Investigators* Background-In patients with syncope and bundle branch block (BBB), syncope is suspected to be attributable to a paroxysmal atrioventricular (AV) block, but little is known of its mechanism when electrophysiological study is negative. Methods and Results-We applied an implantable loop recorder in 52 patients with BBB and negative conventional workup. During a follow-up of 3 to 15 months, syncope recurred in 22 patients (42%), the event being documented in 19 patients after a median of 48 days. The most frequent finding, recorded in 17 patients, was one or more prolonged asystolic pause mainly attributable to AV block; the remaining 2 patients had normal sinus rhythm or sinus tachycardia. The onset of the bradycardic episodes was always sudden but was sometimes preceded by ventricular premature beats. The median duration of the arrhythmic event was 47 seconds. An additional 3 patients developed nonsyncopal persistent III-degree AV block, and 2 patients had presyncope attributable to AV block with asystole. No patients suffered injury attributable to syncopal relapse. Conclusions-In patients with BBB and negative electrophysiological study, most syncopal recurrences have a homogeneous mechanism that is characterized by prolonged asystolic pauses, mainly attributable to sudden-onset paroxysmal AV block.

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Diagnostic value of programmed ventricular stimulation in patients with bifascicular block: A prospective study of patients with and without syncope

Cited by 87 publications

References 31 publications

Clinical Impact of Persistent Left Bundle-Branch Block After Transcatheter Aortic Valve Implantation With CoreValve Revalving System

Clinical Impact of Persistent Left Bundle-Branch Block After Transcatheter Aortic Valve Implantation With CoreValve Revalving System

Bundle-Branch Block in a General Male Population

Mechanism of Syncope in Patients With Bundle Branch Block and Negative Electrophysiological Test

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