Long‐term prognosis in patients with bifascicular block – the predictive value of noninvasive and invasive assessment

Tabrizi, Fariborz; Rosenqvist, Mårten; Bergfeldt, Lennart; Englund, Anders

doi:10.1111/j.1365-2796.2006.01651.x

Cited by 14 publications

(2 citation statements)

References 32 publications

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“…Although syncope is not associated with an increased incidence of sudden death in patients with preserved cardiac function, a high incidence of total deaths (about one-third sudden) was observed in patients with BBB and heart failure, previous myocardial infarction, or low ejection fraction. [345][346][347] Indeed, the high total and sudden mortality seems to be mainly related to underlying structural heart disease and ventricular tachyarrhythmias. In this latter situation, syncope is a risk factor, rather than the cause, of death.…”

Section: Bundle Branch Block and Unexplained Syncopementioning

confidence: 99%

2018 ESC Guidelines for the diagnosis and management of syncope

Brignole¹,

Moya²,

Lange³

et al. 2018

Kardiol Pol

237

353

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Section: Bundle Branch Block and Unexplained Syncopementioning

confidence: 99%

2018 ESC Guidelines for the diagnosis and management of syncope

Brignole¹,

Moya²,

Lange³

et al. 2018

Kardiol Pol

237

353

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“…8,11,[25][26][27][28] Despite the high incidence of electric disturbances of the conduction system, EPS at the time of the hospital observation has limited positive predictive value. 10,14,29,30 Accordingly, BFB patients with both history of previous syncope and a negative EPS have been the subject of several investigations involving pacemakers or loop recorders to identify the nature of associated syncopal recurrences and consequently its most appropriate treatment. 5,24,27,31,32 Current guidelines set, in the past 10 years, a class IIA recommendation for a pacemaker implantation in patients with BFB and experiencing syncope of apparently unexplained origin, to avoid the risk of syncopal recurrences and potential physical trauma.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Syncope Through Permanent Cardiac Pacing in Patients With Bifascicular Block and Syncope of Unexplained Origin

Santini

Castro

Giada

et al. 2013

Circ: Arrhythmia and Electrophysiology

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Background— Syncope in patients with bifascicular block (BFB) is a common event whose causes might be difficult to assess. Methods and Results— Prevention of syncope through permanent cardiac pacing in patients with bifascicular block (PRESS) is a multicenter, prospective, randomized, single-blinded study designed to demonstrate a reduction in symptomatic events in patients with bifascicular block and syncope of undetermined origin implanted with permanent pacemaker. Device programming mode (NASPE/BPEG code) at DDD with a lower rate of 60 ppm is compared with backup pacing at DDI with a lower rate of 30 ppm. The end point consisted of (1) syncope, (2) symptomatic presyncopal episodes associated with a device intervention (ventricular pacing), and (3) symptomatic episodes associated with intermittent or permanent atrioventricular block (any degree). One hundred one patients were enrolled and randomized. Primary end point events at 2 years were observed in 23 patients, with a significant lower incidence in the study group (hazard ratio, 0.32; 95% confidence interval [CI], 0.10–0.96; P =0.042). Reduction of any symptoms, associated or not with device intervention, was superior in DDD60 compared with DDI30 (hazard ratio, 0.4; 95% confidence interval, 0.25–0.78; P =0.0053). Fourteen patients developed other rhythm diseases and met class I indication for pacing. The annual incidence of rhythm disease development was 7.4%. Conclusions— In patients with bifascicular block and syncope of undetermined origin, the use of a dual chamber pacemaker programmed to DDD60 led to a significant reduction of syncope or symptomatic events associated with a cardioinhibitory origin, compared with DDI30 programming. Symptoms associated with a new onset of rhythm disease were found in 15% of the population at 2 years.

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Electrophysiology Testing: Appropriate Indications in TLOC/Collapse

Sorajja

2020

Syncope

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Long‐term prognosis in patients with bifascicular block – the predictive value of noninvasive and invasive assessment

Cited by 14 publications

References 32 publications

2018 ESC Guidelines for the diagnosis and management of syncope

2018 ESC Guidelines for the diagnosis and management of syncope

Prevention of Syncope Through Permanent Cardiac Pacing in Patients With Bifascicular Block and Syncope of Unexplained Origin

Electrophysiology Testing: Appropriate Indications in TLOC/Collapse

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