Implications of left bundle branch block in acute myocardial infarction treated with primary angioplasty

New or presumed new left bundle branch block in patients with suspected ST-elevation myocardial infarction

“…New LBBB occurred in 3.3% of patients in this large regional STEMI system (consistent with previous reports 0.5–6.7%) and therefore represents an important clinical subset. 16–18,22–30 Patients with new LBBB were older, more likely to be women and were more likely to have previous coronary artery disease (previous MI, PCI and CABG) findings consistent with previous reports. 17,18,23–30 The angiographic data presented here represent the largest report to date in patients with new LBBB, and document an acute culprit lesion in 54%.…”

“…16–18,22–30 Patients with new LBBB were older, more likely to be women and were more likely to have previous coronary artery disease (previous MI, PCI and CABG) findings consistent with previous reports. 17,18,23–30 The angiographic data presented here represent the largest report to date in patients with new LBBB, and document an acute culprit lesion in 54%. 17,22,23,28–30 Mortality was higher for new LBBB patients at 1 year even after adjustment for the differences in comorbidities.…”

“…17,18,[23][24][25][26][27][28][29][30] The angiographic data presented here represent the largest report to date in patients with new LBBB, and document an acute culprit lesion in 54%. 17,22,23,[28][29][30] Mortality was higher for new LBBB patients at 1 year even after adjustment for the differences in comorbidities.…”

Hypertrophies and Intraventricular Conduction Defects

“…8,[23][24][25][26][27] Of concern is that these patients may be exposed to the dangers of thrombolytics when they are experiencing either unstable angina or a nonYQ-wave AMI. 28 The question of when to treat patients with an LBBB and suspected AMI has long been of concern and precedes the thrombolytic era. [23][24][25] Over time, various strategies for using the ECG to identify which patients with LBBB were experiencing AMI have been proposed.…”

Electrocardiographic Diagnosis of Myocardial Infarction during Left Bundle Branch Block

“…As such, although the criteria and the algorithm cannot be used to rule out MI, it can help to rule it in. Patients with an acute MI and LBBB have a high mortality rate, but this is significantly related to age and comorbidities [22][23][24]. Thus, these markers should be used together with the clinical findings because the ECG markers alone miss acute MI in many patients who would benefit from aggressive Table 3 Application of ST-segment criteria for the diagnosis of AMI in the 300 patients with LBBB at randomization from Wong and colleagues [4] Table 2 Odds ratios and scores for independent electrocardiographic criteria from Sgarbossa and colleagues [1] Criterion…”