Incomplete bilateral bundle branch block and A-V block complicating acute anterior wall myocardial infarction

Fenig, Sidney; Lichstein, Edgar

doi:10.1016/0002-8703(72)90303-1

Cited by 25 publications

(4 citation statements)

References 16 publications

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“…This effect of the timing of onset of block on mortality was demonstrated by Lie et al26 for patients having RBBB with or without fascicular blocks, and in the present study for patients having RBBB + LAFB. Other investigators have not found that th, age of the bundle branch block significantly influences mortality.8 23 24 When bundle branch block complicates acute myocardial infarction, the site of infarction is usually anteroseptal.8' 10,13,15,17,20,22,24,26,28 In this study, 75% of the infarctions which could be localized were anterior. The relatively small number of patients with inferior or posterior infarctions had a lower risk of dying during or after hospitalization than patients with anterior or indeterminant location infarcts.…”

Section: Discussionmentioning

confidence: 55%

The clinical significance of bundle branch block complicating acute myocardial infarction. 1. Clinical characteristics, hospital mortality, and one-year follow-up.

Hindman¹,

Wagner²,

JaRo³

et al. 1978

Circulation

242

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To provide an understanding of the clinical characteristics of patients with acute myocardial infarction (MI) and bundle branch block, experience from five centers was accumulated. Patients in whom bundle branch block first appeared after the onset of cardiogenic shock were excluded. In 432 patients, the most common types of block were left (38%) and right with left anterior fascicular block (34%). In 42% of the patients, bundle branch block was new. Progression to high degree (second or third degree) atrioventricular (AV) block via a Type II pattern occurred in 22% of the patients. Hospital and first year follow-up mortality rates were 28% and 28%, respectively. Only 46% of the patients developed pulmonary edema or shock (Killip Class III or IV), and hospital mortality was related to the amount of heart failure (8%, 7%, 27%, 83% for Killip Classes I-IV, respectively). Patients with progression to second degree or third degree AV block via a Type II pattern had increased hospital mortality compared with patients without this complication (47% vs 23%, P less than 0.001). In the absence of pulmonary edema or shock, patients with Type II second degree or third degree AV block still had a higher mortality rate than patients without advanced AV block (31% vs 2%, P less than 0.005), with nearly all the deaths due to abrupt development of AV block. Thus, in many patients MI with bundle branch block is associated with severe heart failure. However, this was not true for a majority of the patients, in whom therapy aimed at preventing morbidity and mortality due to the bradyarrhythmia of advanced AV block might be beneficial.

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Section: Discussionmentioning

confidence: 55%

The clinical significance of bundle branch block complicating acute myocardial infarction. 1. Clinical characteristics, hospital mortality, and one-year follow-up.

Hindman¹,

Wagner²,

JaRo³

et al. 1978

Circulation

242

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“…Another group of researcher from New York City reported high incidence of mortality and morbidity including ventricular fibrillation and sudden cardiac arrest among the patients with acute LBBB. 20 Wellen's syndrome, mostly destined to a massive anterior wall myocardial infarction was found to be present in 12.5%(n=10) patients in our study. This was the least involved pattern and a similar results was found in a study where out of 120 patients presenting with ACS, 18(15%) patients fulfilled wellen's syndrome criteria and among them those involving the Proximal LAD artery were as low as 4 patients where none of them fulfilled STEMI.…”

Section: Resultsmentioning

confidence: 44%

Electrocardiography Patterns in Patients With Proximal Left Anterior Descending Coronary Artery Stenosis

Shrestha,

Bhusal

2024

JCMC

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Background: Stenosis of proximal left anterior descending coronary artery presents with diverse electrocardiographic patterns. This study aimed to determine different types of ECG changes and their frequency in patients with proximal left anterior descending coronary artery stenosis. Methods: This descriptive cross-sectional study was conducted at the Department of Cardiology, College of Medical Sciences, Bharatpur from Ist June 2023 to 30 October 2023. Patients who underwent coronary angiography and had proximal left coronary artery stenosis were included in the study. Total 80 such patients were evaluated. Electrocardiographic changes in these patients was noted. Proximal left anterior descending coronary artery stenosis was independent variable and ECG changes were dependent variables. The ECG changes were ST elevations in leads I, aVL and precordial leads V1-V6, ST elevations in V1-V6, De Winter’s T-wave pattern, acute LBBB and Wellen’s Syndrome. Frequency of varying electrocardiographic changes in proximal left anterior descending coronary artery stenosis was evaluated. Results: Electrocardiographic analysis of proximal left anterior descending artery revealed diverse patterns. 37.5% (n=25) had ST elevations in leads I, aVL and V1-V6. 25% (n=20) had ST elevations in V1-V6. De Winter’s T-wave pattern was seen in 16.25% (n=13) patients. Left bundle branch block was present in 15% (n=12). A Wellen’s Syndrome was present in 12.5% (n=10). Conclusions: Proximal LAD artery stenosis reveals significant diversity in ECG patterns.

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“…This increased mortality is related to both a greater amount of myocardial damage and a greater risk of complete heart block and asystole (Fenig and Lichstein, 1972).…”

mentioning

confidence: 99%

“…These include right bundle-branch block with left anterior hemiblock, right bundle-branch block with left posterior hemiblock, alternating right bundle-branch block and left bundle-branch block in the same or serial tracings, and first degree atrioventricular block with bundle-branch block and an unusually prolonged QRS. Though some reservations exist (Godman et al,I970;Scheinman and Brenman,I972), immediate insertion of a Received 3 February 1975. 'Portions of this study were presented at the 47th Session of the American Heart Association in Dallas, Texas, November, I974. temporary prophylactic pacemaker when incomplete bundle-branch block complicates acute myocardial infarction has been widely recommended (Atkins et al, 1973;Fenig and Lichstein, 1972;Roos and Dunning, I970;Norris, I969;Lassers and Juhan, I968). The mortality remains high despite this therapeutic intervention (Gould et al, 1972).…”

mentioning

confidence: 99%

Long-term survival of patients with incomplete bundle-branch block complicating acute myocardial infarction.

Lichstein¹,

Gupta²,

Chadda³

1975

Heart

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Bundle-branch block complicating acute myocardial infarction is associated with an increased mortality (Godman, Lassers, and Julian, I970; Atkins et al., 1973). This increased mortality is related to both a greater amount of myocardial damage and a greater risk of complete heart block and asystole (Fenig and Lichstein, 1972).Various forms of incomplete bilateral bundlebranch block have been recognized as precursors of complete heart block (Scanlon, Pryor, and Blount, I970). These include right bundle-branch block with left anterior hemiblock, right bundle-branch block with left posterior hemiblock, alternating right bundle-branch block and left bundle-branch block in the same or serial tracings, and first degree atrioventricular block with bundle-branch block and an unusually prolonged QRS. Though some reservations exist (Godman et al., I970; Scheinman and Brenman, I972), immediate insertion of a

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Incomplete bilateral bundle branch block and A-V block complicating acute anterior wall myocardial infarction

Cited by 25 publications

References 16 publications

The clinical significance of bundle branch block complicating acute myocardial infarction. 1. Clinical characteristics, hospital mortality, and one-year follow-up.

The clinical significance of bundle branch block complicating acute myocardial infarction. 1. Clinical characteristics, hospital mortality, and one-year follow-up.

Electrocardiography Patterns in Patients With Proximal Left Anterior Descending Coronary Artery Stenosis

Long-term survival of patients with incomplete bundle-branch block complicating acute myocardial infarction.

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